目的探讨中性粒细胞CD64、C反应蛋白(CRP)、降钙素原(PCT)及中性粒细胞与淋巴细胞比值(NLR)在儿童社区获得性肺炎(CAP)中的诊断价值。方法选取海口市人民医院收治的CAP患儿186例,依据病原体不同分为细菌性肺炎组(95例),支原体肺炎组(43...目的探讨中性粒细胞CD64、C反应蛋白(CRP)、降钙素原(PCT)及中性粒细胞与淋巴细胞比值(NLR)在儿童社区获得性肺炎(CAP)中的诊断价值。方法选取海口市人民医院收治的CAP患儿186例,依据病原体不同分为细菌性肺炎组(95例),支原体肺炎组(43例)和病毒性肺炎组(48例)。细菌性肺炎患儿依据入院病情严重程度分为轻症组(75例)和重症组(20例)。采用流式细胞术检测外周血中性粒细胞CD64的表达,同时检测CRP、PCT及NLR水平。应用ROC曲线分析CD64、CRP、PCT及NLR水平对细菌性肺炎的诊断价值。结果细菌性肺炎组治疗前CD64(8.85±3.40 vs 2.26±0.74,2.42±0.95,2.38±0.80)、CRP(38.62±8.50 vs 3.25±0.96,3.42±1.15,4.16±1.53,mg/L)、PCT(6.17±1.40 vs 0.15±0.03,0.34±0.12,0.62±0.28,ng/mL)及NLR(7.84±3.25 vs 2.05±0.96,1.37±0.62,2.48±1.16)水平均明显高于对照组、病毒性肺炎组和支原体肺炎组(P<0.01)。细菌性肺炎患儿治疗后CD64(2.70±1.06 vs 8.85±3.40)、CRP(4.63±1.58 vs 38.62±8.50,mg/L)、PCT(0.21±0.06 vs 6.17±1.40,ng/mL)及NLR(2.28±1.07 vs 7.84±3.25)水平均明显低于治疗前(P<0.01)。重症细菌性肺炎患儿CD64(10.42±4.36 vs 7.60±2.58)、CRP(43.25±10.47 vs 34.85±8.16,mg/L)、PCT(9.26±2.18 vs 4.62±1.15,ng/mL)及NLR(9.75±4.12 vs 6.53±2.90)水平均明显高于轻症细菌性肺炎(P<0.01)。ROC曲线分析显示,CD64、CRP、PCT及NLR单项指标诊断细菌性肺炎的最佳截值分别为3.25、14.80 mg/L、1.83 ng/mL、4.37,四项联合诊断细菌性肺炎的AUC(0.948,95%CI:0.887~0.992)最大,其敏感度和特异度为96.2%和89.3%。Pearson相关分析显示,细菌性肺炎患儿CD64与CRP、PCT及NLR呈正相关(r=0.573、0.729、0.536,P<0.01),CRP与PCT及NLR呈正相关(r=0.602、0.497,P<0.01),PCT与NLR呈正相关(r=0.514,P<0.01)。结论CD64、CRP、PCT及NLR四项联合检测有助于提高细菌性肺炎的诊断价值,并可作为判断CAP患儿病情严重程度的实验室指标。展开更多
Diabetic retinopathy(DR) is the most feared ocular manifestation of diabetes. DR is characterized by progressive retinal damage that may eventually result in blindness. Clinically, this blindness is caused by progress...Diabetic retinopathy(DR) is the most feared ocular manifestation of diabetes. DR is characterized by progressive retinal damage that may eventually result in blindness. Clinically, this blindness is caused by progressive damage to the retinal microvasculature, which leads to ischemia, retinal swelling, and neovascularization. Retinopathy is associated with both type 1 and type 2 diabetes, with DR being the leading cause of new onset blindness in United States adults. Despite this strong association with diabetes, it must be noted that the development of retinopathy lesions is multifactorial and may occur in individuals without an established history of diabetes. Metabolic syndrome is a multifactorial condition of central obesity, hypertriglyceridemia, dyslipidemia, hypertension, fasting hyperglycemia, and insulin resistance. Although several studies examined the individual components observed in the metabolic syndrome in relation to the development of DR, there is conflicting data as to the association of the metabolic syndrome with the development of retinopathy lesions in nondiabetic subjects. This review will summarize the current literature on the evidence of the metabolic syndrome on retinopathy in subjects with and without an established history of diabetes. This review will also discuss some of the mechanisms through which metabolic syndrome can contribute to the development of retinopathy.展开更多
Mucinous cystadenoma of the appendix is a rare condition and represents one of the three entities with the common name mucocele of the appendix. It is characterized by a cystic dilatation of the lumen with stasis of m...Mucinous cystadenoma of the appendix is a rare condition and represents one of the three entities with the common name mucocele of the appendix. It is characterized by a cystic dilatation of the lumen with stasis of mucus inside it. Histopathologically mucocele is divided into three groups： focal or diffuse mucosal hyperplasia, mucinous cystadenoma and mucinous cystadenocarcinoma. This condition is often associated with other neoplasia, especially adenocarcinoma of the colon and ovaries. We here describe a 57 year old male patient who presented with abdominal discomfort, constipation, fresh blood in stool and frequent urination. He had a big cystadenoma of the appendix associated with adenocarcinoma of the colon and hepatocellular carcinoma of the liver. The patient underwent right haemicolectomy, sigmoid colon resection and segmental resection of the liven Now 3 years later he has no evidence of disease relapse. According to this, we stress the need of accurate preoperative diagnosis and intraoperative exploration of the whole abdomen in these patients.展开更多
A 90-day experiment was conducted to investigate the effects of different dietary linoleic acid （LA; 18：2n-6） and linolenic acid ratios （LNA; 18：3n-3） on growth induces, feed utilization and tissue fatty acid pr...A 90-day experiment was conducted to investigate the effects of different dietary linoleic acid （LA; 18：2n-6） and linolenic acid ratios （LNA; 18：3n-3） on growth induces, feed utilization and tissue fatty acid profile of freshwater prawn, Macrobrachium rosenbergii post-larvae （PL）. The experiment was conducted in cubic indoor fiberglass tanks, each holding 700 L in triplicate. Post-larvae with an average weight of 20.8 ± 0.20 mg were stocked at 80 PL m2. Five experimental isocaloric （15.06 MJ kgl digestible energy）, and isonitrogenous （30.45% digestible protein） diets were formulated by blending of soybean oil and linseed oil to containing five dietary LA/LNA ratios （7.80, 2.75, 1.28, 0.65 and 0.30）. The highest survival values were recorded for prawn PL fed diet containing 0.65 LA/LAN ratios. Growth indices of PL significantly increased （P 〈 0.05） with decreased dietary LA/LAN ratios to 0.65. The same trend was observed for the highest （P ≤ 0.05） protein efficiency ratio, protein productive value, fat retention, energy retention and best feed conversion ratio. The total whole tissue polyunsaturated fatty acid composition of M. rosenbergii PL was dominated by LA followed by LAN. Post larvae fed the diets containing higher LA/LNA ratios showed a higher tissue LA/LNA ratio. The obtained findings revealed that fatty acid patterns ofM. rosenbergii PL were influenced by fatty acid profiles of diets. The diet containing 0.65 LA/LNA ratio is recommended to obtaining optimum growth performance and feed utilization for M. rosenbergii PL.展开更多
Immune reactivity and chronic low-grade inflammation(metaflammation) play an important role in the pathogenesis of obesity-associated metabolic disorders, including type 2 diabetes and nonalcoholic fatty liver disease...Immune reactivity and chronic low-grade inflammation(metaflammation) play an important role in the pathogenesis of obesity-associated metabolic disorders, including type 2 diabetes and nonalcoholic fatty liver disease(NAFLD), a spectrum of diseases that include liver steatosis, nonalcoholic steatohepatitis(NASH), fibrosis, and cirrhosis. Increased adiposity and insulin resistance contribute to the progression from hepatic steatosis to NASH and fibrosis through the development of proinflammatory and profibrotic processes in the liver, including increased hepatic infiltration of innate and adaptive immune cells, altered balance of cytokines and chemokines, increased reactive oxygen species generation and hepatocellular death. Experimental models of dietary-induced NAFLD/NASH in mice on different genetic backgrounds or knockout mice with different immune reactivity are used for elucidating the pathogenesis of NASH and liver fibrosis. Galectin-3(Gal-3), a unique chimera-type β-galactoside-binding protein of the galectin family has a regulatory role in immunometabolism and fibrogenesis. Mice deficient in Gal-3 develop pronounced adiposity, hyperglycemia and hepatic steatosis, as well as attenuated liver inflammation and fibrosis when fed an obesogenic high-fat diet. Interleukin(IL)-33, a member of the IL-1 cytokine family, mediates its effects through the ST receptor, which is present on immune and nonimmune cells and participates in immunometabolic and fibrotic disorders. Recent evidence, including our own data, suggests a protective role for the IL-33/IL-33R(ST2) signaling pathway in obesity, adipose tissue inflammation and atherosclerosis, but a profibrotic role in NASH development. The link between Gal-3 and soluble ST2 in myocardial fibrosis and heart failure progression has been demonstrated and we have recently shown that Gal-3 and the IL-33/ST2 pathway interact and both have a profibrotic role in diet-induced NASH. This review discusses the current evidence on the roles of Gal-3 and the IL-33/ST2 pathway and 展开更多
Let (X, ρ) be a metric space and ↓USCC(X) and ↓CC(X) be the families of the regions below all upper semi-continuous compact-supported maps and below all continuous compact-supported maps from X to I = [0,1], respec...Let (X, ρ) be a metric space and ↓USCC(X) and ↓CC(X) be the families of the regions below all upper semi-continuous compact-supported maps and below all continuous compact-supported maps from X to I = [0,1], respectively. With the Hausdorff-metric, they are topological spaces. In this paper, we prove that, if X is an infinite compact metric space with a dense set of isolated points, then (↓USCC(X), ↓CC(X)) ≈ (Q, c 0 ∪ (Q Σ)), i.e., there is a homeomorphism h:↓USCC(X) → Q such that h(↓CC(X)) = c 0 ∪ (Q Σ), where Q = [?1,1]ω, Σ = {(x n ) n∈? ∈ Q: sup|x n | < 1} and c 0 = {(x n ) n∈? ∈ Σ: lim n→+∞ x n = 0}. Combining this statement with a result in our previous paper, we have $$ ( \downarrow USCC(X), \downarrow CC(X)) \approx \left\{ \begin{gathered} (Q,c_0 \cup (Q\backslash \Sigma )), if the set of isolanted points is dense in X, \hfill \\ (Q,c_0 ),otherwise, \hfill \\ \end{gathered} \right. $$ if X is an infinite compact metric space. We also prove that, for a metric space X, (↓USCC(X), ↓CC(X)) ≈ (Σ, c 0) if and only if X is non-compact, locally compact, non-discrete and separable.展开更多
AIM: To determine clinical characteristics and treatment outcome of gastric lymphoma after chemotherapy and immuno-chemotherapy. METHODS: Thirty four patients with primary gastric mucosa associated lymphoid tissue (MA...AIM: To determine clinical characteristics and treatment outcome of gastric lymphoma after chemotherapy and immuno-chemotherapy. METHODS: Thirty four patients with primary gastric mucosa associated lymphoid tissue (MALT) lymphoma (Ann Arbor stages Ⅰ to Ⅳ) were enrolled. All had upper gastric endoscopy, abdominal ultrasonography, CT and H pylori status assessment (histology and serology). After anti-H pylori treatment and initial chemotherapy, patients were re-examined every 4 mo. RESULTS: Histological regression of the lymphoma was complete in 22/34 (64.7%) and partial in 9 (26.5%) patients. Median follow up time for these 31 responders was 60 mo (range 48-120). No regression was noted in 3 patients. Among the 25 (73.5%) H pylori positive patients, the eradication rate was 100%.CONCLUSION: Using univariate analysis, predictive factors for overall survival were international prognostic index (IPI) score, hemoglobin level, erythrocyte sedimentation rate (ESR), and platelet numbers (P < 0.005). In addition to this, Cox proportion hazard model differentiate IPI score, ESR, and platelets as predictors of survival.展开更多
AIM To investigate the effect of adipose-derived mesenchymal stem cells(ADMSCs)and their conditioned media(CM) on hepatocellular carcinoma(HCC) cell tumorigenesis.METHODS The proliferation rate of HepG2 and PLC-PRF-5 ...AIM To investigate the effect of adipose-derived mesenchymal stem cells(ADMSCs)and their conditioned media(CM) on hepatocellular carcinoma(HCC) cell tumorigenesis.METHODS The proliferation rate of HepG2 and PLC-PRF-5 HCC cancer cells was measured using the trypan blue exclusion method and confirmed using the cell-counting kit8(commonly known as CCK-8) assay. Apoptosis was detected by flow cytometry using annexin V-FITC. Protein and mRNA expression was quantified by ELISA and real time PCR, respectively. Migration and invasion rates were performed by Transwell migration and invasion assays. Wound healing was examined to confirm the data obtained from the migration assays.RESULTS Our data demonstrated that when co-culturing HCC cell lines with ADMSCs or treating them with ADMSC CM, the HCC cell proliferation rate was significantly inhibited and the apoptosis rate increased. The decreased proliferation rate was accompanied by an upregulation of P53 and Retinoblastoma mRNA and a downregulation of c-Myc and hTERT mRNA levels. More notably, ADMSCs and their CM suppressed the expression of the two important markers of HCC carcinogenicity, alpha-fetoprotein and Des-gamma-carboxyprothrombin. In addition, the migration and invasion levels of HepG2 and PLC-PRF-5 cells significantly decreased, potentially through increased expression of the tissue inhibitor metalloproteinases TIMP-1, TIMP-2 and TIMP-3.CONCLUSION These findings shed new light on a protective and therapeutic role for ADMSCs and their CM in controlling HCC invasiveness and carcinogenesis.展开更多
The Rosoideae is a subfamily of the Rosaceae that contains a number of species of economic importance,including the soft fruit species strawberry(Fragaria 3ananassa),red(Rubus idaeus)and black(Rubus occidentalis)raspb...The Rosoideae is a subfamily of the Rosaceae that contains a number of species of economic importance,including the soft fruit species strawberry(Fragaria 3ananassa),red(Rubus idaeus)and black(Rubus occidentalis)raspberries,blackberries(Rubus spp.)and one of the most economically important cut flower genera,the roses(Rosa spp.).Molecular genetics and genomics resources for the Rosoideae have developed rapidly over the past two decades,beginning with the development and application of a number of molecular marker types including restriction fragment length polymorphisms,amplified fragment length polymorphisms and microsatellites,and culminating in the recent publication of the genome sequence of the woodland strawberry,Fragaria vesca,and the development of high throughput single nucleotide polymorphism(SNP)-genotyping resources for Fragaria,Rosa and Rubus.These tools have been used to identify genes and other functional elements that control traits of economic importance,to study the evolution of plant genome structure within the subfamily,and are beginning to facilitate genomic-assisted breeding through the development and deployment of markers linked to traits such as aspects of fruit quality,disease resistance and the timing of flowering.In this review,we report on the developments that have been made over the last 20 years in the field of molecular genetics and structural genomics within the Rosoideae,comment on how the knowledge gained will improve the efficiency of cultivar development and discuss how these advances will enhance our understanding of the biological processes determining agronomically important traits in all Rosoideae species.展开更多
AIM:This paper describes the procedure of detection of Helicobacter pylori(H.pylori)in bile specimens in patients suffering from benign diseases of biliary ducts(lithiasis with/without nonspecific cholangitis). METHOD...AIM:This paper describes the procedure of detection of Helicobacter pylori(H.pylori)in bile specimens in patients suffering from benign diseases of biliary ducts(lithiasis with/without nonspecific cholangitis). METHODS:The group of 72 patients entering the study consisted of 32 male and 40 female(45 % and 55 %, respectively).Bile was obtained during ERCP in 68 patients, and during cholecystectomy in 4 patients.A fast urease test (FUT)to determine the existence of H.pylori in gastric mucosa was carried out for all the patients during the endoscopic examination.The existence of genetic material of H.pylori was determined by detection of ure A gene by the method of nested PCR.The results of this reaction were shown by electrophoresis on 10 g·L^(-1)agarose gel in a band of 256 bp. RESULTS:The majority of the patients included in our study had biliary lithiasis without signs of cholangitis(48 patients, 67 %),whereas other patients were complicated by cholangitis(17 patients,24 %).Seven patients(9 %)had normal ERCP,forming thus the control group.In the group of patients with lithiasis 26 patients(24.2 %)had positive PCR of H.pylori in bile and among the patients with associated cholangitis positive PCR was detected in 9 patients(52.9 %).Among the seven patients with normal ERCP only one(14 %)had positive PCR of H.pylori.A high percentage of H.pylori infection of gastric mucosa was observed(57 patients,79 %).It was also observed that its slightly higher positivity was in the patients with distinct bile pathology:81% FLIT positive patients in the group with choledocholithiasis alone and 76 % in the group with choledocholithiasis associated with cholangitis.Seventy-one percent of the patients with regular findings had positive FUT.CONCLUSION: The prevalence of H. pylori infection both in bile and in gastric mucosa in patients with benign diseases of biliary ducts does not show a statistically significant difference in relation to the prevalence of the same with the patients with normal ERCP. The existence of H. pylori in展开更多
Polymer electrolyte membrane(PEM)fuel cells are electrochemical devices that directly convert the chemical energy stored in fuel into electrical energy with a practical conversion efficiency as high as 65%.In the past...Polymer electrolyte membrane(PEM)fuel cells are electrochemical devices that directly convert the chemical energy stored in fuel into electrical energy with a practical conversion efficiency as high as 65%.In the past years,significant progress has been made in PEM fuel cell commercialization.By 2019,there were over 19,000 fuel cell electric vehicles(FCEV)and 340 hydrogen refueling stations(HRF)in the U.S.(~8,000 and 44,respectively),Japan(~3,600 and 112,respectively),South Korea(~5,000 and 34,respectively),Europe(~2,500 and 140,respectively),and China(~110 and 12,respectively).Japan,South Korea,and China plan to build approximately 3,000 HRF stations by 2030.In 2019,Hyundai Nexo and Toyota Mirai accounted for approximately 63%and 32%of the total sales,with a driving range of 380 and 312 miles and a mile per gallon(MPGe)of 65 and 67,respectively.Fundamentals of PEM fuel cells play a crucial role in the technological advancement to improve fuel cell performance/durability and reduce cost.Several key aspects for fuel cell design,operational control,and material development,such as durability,electrocatalyst materials,water and thermal management,dynamic operation,and cold start,are briefly explained in this work.Machine learning and artificial intelligence(AI)have received increasing attention in material/energy development.This review also discusses their applications and potential in the development of fundamental knowledge and correlations,material selection and improvement,cell design and optimization,system control,power management,and monitoring of operation health for PEM fuel cells,along with main physics in PEM fuel cells for physics-informed machine learning.The objective of this review is three fold:(1)to present the most recent status of PEM fuel cell applications in the portable,stationary,and transportation sectors;(2)to describe the important fundamentals for the further advancement of fuel cell technology in terms of design and control optimization,cost reduction,and durability improvement;and(3)to 展开更多
Glanzmann thrombasthenia (GT) is a rare and often underdiagnosed congenital bleeding disorder caused by mutations in the genes encoding glycoproteins GPIIb or GPIIIa, resulting in platelet dysfunction. Inherited in an...Glanzmann thrombasthenia (GT) is a rare and often underdiagnosed congenital bleeding disorder caused by mutations in the genes encoding glycoproteins GPIIb or GPIIIa, resulting in platelet dysfunction. Inherited in an autosomal recessive manner, GT is characterized by the inability of platelets to aggregate. Clinically, it presents with mucocutaneous bleeding, such as easy and extensive bruising, severe epistaxis, menorrhagia, gingival bleeding, postpartum hemorrhage, and unexpected bleeding following procedures, despite a normal platelet count. We present a case involving a 6-year-old male patient who experienced spontaneous gingival bleeding for the past 4 weeks due to the eruption of his first permanent molars. The bleeding was particularly severe at night, disrupting the child’s sleep. The patient had been diagnosed with GT at the age of 16 months. Dental management was pursued, and the use of tranexamic acid mouthwash, combined with meticulous oral hygiene, resulted in an excellent response.展开更多
Introduction: Primary hyperoxaluria type 1 (HP1) is a rare lithiasis with systemic involvement, due to the accumulation of calcium oxalate crystals. In the absence of therapeutic management, it progresses to end-stage...Introduction: Primary hyperoxaluria type 1 (HP1) is a rare lithiasis with systemic involvement, due to the accumulation of calcium oxalate crystals. In the absence of therapeutic management, it progresses to end-stage chronic renal failure. The aim of this study is to describe and analyse the observations of our patients with HP1. Patients and methods: This is a retrospective study carried out between 2014 and 2023 in the Nephrology-Dialysis Transplant Department of the Ibn Sina University Hospital in Rabat. The clinical, paraclinical and evolutionary elements were taken from the patients’ medical records. Results: We collected 11 cases, with a mean age of 27 ± 8.5 years and a M/F sex ratio of 1.7. The diagnosis of HP1 was made on the basis of genetic analysis in 8 patients, morphological and spectro-photometric analysis of the calculus in one patient, biopsy of the graft in one patient and crystalluria and a family history of PH1 in one patient. Two patients died, and 8 patients were on chronic haemdialysis with systemic damage. Only one patient maintained a stable GFR at 60 ml/min. Conclusion: Early diagnosis combined with conservative treatment is the only way to limit the rapid progression of this disease. This requires awareness and collaboration between nephrologists, urologists and biologists within a specialised team.展开更多
The treatment of hepatitis C has undergone a significant boom since the advent of direct acting antivirals (DAA). Indeed, the interferon-ribavirin combination that has been used to treat hepatitis C has a virological ...The treatment of hepatitis C has undergone a significant boom since the advent of direct acting antivirals (DAA). Indeed, the interferon-ribavirin combination that has been used to treat hepatitis C has a virological response in only 45% of cases with significant side effects. The advent of direct-acting antivirals has changed the prognosis of cirrhotic patients with hepatitis C. DAAs have ensured a sustained viral response in the majority of patients. Our work aims to see the evolution of hepatitis C patients at the cirrhosis stage under DAA. We conducted a retrospective study over 15 years (January 2009, January 2024) including all patients with post-viral cirrhosis C, whom we divided into two groups: group A, cirrhotic patients who received ribavirin and interferon, and group B, patients on DAA. From January 2009 to January 2024, we conducted a study of 182 patients with viral hepatitis C, including 102 cirrhotic patients. The mean age was 55 years. 66% of patients were initially treated with the ribavirin interferon combination, while 34% received direct-acting antivirals (DAAs). Since the introduction of DAAs, the most commonly used regimens have been sofosbuvir/daclatasvir with or without ribavirin and sofosbuvir/ledipasvir with or without ribavirin. Group A achieved sustained virological response (SVR) in 60% of cases, with notable side effects. In Group B, SVR was 98.18%, with improved tolerability and fewer side effects than previous treatments. Fifteen patients developed hepatocellular carcinoma (HCC), with a significantly lower mortality rate in those treated with DAAs compared with pegylated dual therapy (p: 0.001).展开更多
Hypoxic hepatitis, also known as ischemic hepatitis, is characterized by acute hepatocellular injury due to inadequate oxygen delivery to the liver. Celiac trunk stenosis can lead to hepatic ischemia and subsequent li...Hypoxic hepatitis, also known as ischemic hepatitis, is characterized by acute hepatocellular injury due to inadequate oxygen delivery to the liver. Celiac trunk stenosis can lead to hepatic ischemia and subsequent liver damage. We present the case of an 81-year-old patient with a history of hypertension, ischemic heart disease, hypothyroidism, and biliary lithiasis, who developed hypoxic hepatitis secondary to Dunbar syndrome and a stenosis of the superior mesenteric artery. The patient improved symptoms and liver function tests with conservative management, including intravenous fluids and supportive care. Long-term management involved continued antiplatelet therapy and statins, with consideration of further interventions for celiac trunk stenosis. This case underscores the importance of recognizing Dunbar syndrome as well as superior mesentery trunk stenosis as a potential cause of hypoxic hepatitis. It highlights the need for multidisciplinary management in such cases.展开更多
Background: Peripartum cardiomyopathy (PPCM) is a rare disease that typically affects young, healthy women. Because PPCM is associated with significant mortality, timely diagnosis and management are essential. Ventric...Background: Peripartum cardiomyopathy (PPCM) is a rare disease that typically affects young, healthy women. Because PPCM is associated with significant mortality, timely diagnosis and management are essential. Ventricular tachycardia (VT) is a major complication and contributor to sudden death. Available data on VT in patients with PPCM are limited. Aim: This case report demonstrates the clinical presentation, antenatal care, and management of labor and delivery in a patient with PPCM complicated by VT. Case report: 36-year old patient G4P3 presents at 27 weeks gestation to the emergency department complaining of chest tightness, palpitations, and profuse sweating. Peripartum cardiomyopathy was diagnosed after her last pregnancy a few years prior. Ventricular tachycardia was diagnosed at this visit and treated successfully. The remainder of the pregnancy was uneventful until she had another episode of ventricular tachycardia during labor. Treatment using antiarrhythmics (diltiazem, amiodarone, adenosine) highlights the importance of prompt intervention and the need for a range of therapeutic options. Results: This case demonstrated successful VT management during pregnancy and labor, emphasizing multidisciplinary collaboration, influencing maternal and fetal outcomes positively, providing insights into optimal care strategies. Conclusion: Peripartum cardiomyopathy complicated by ventricular tachycardia is a life-threatening combination. This case highlights the importance of timely diagnosis and management with combined care between cardiologists, maternal fetal medicine specialists and anesthesiologists to prevent morbidities and sudden maternal death.展开更多
Introduction: Autosomal dominant polycystic kidney disease (ADPKD) is a common, multisystemic, and progressive hereditary disease. It accounts for 6 to 8% of incident cases of end-stage chronic renal disease (ESRD) in...Introduction: Autosomal dominant polycystic kidney disease (ADPKD) is a common, multisystemic, and progressive hereditary disease. It accounts for 6 to 8% of incident cases of end-stage chronic renal disease (ESRD) in developed countries. The aim of this study is to describe the predictive factors for the development of end-stage chronic kidney disease (CKD) in the course of this disease. Material and Methods: This is a retrospective, descriptive, and analytical study including 300 cases of ADPKD collected at the Nephrology Department of Ibn-Sina Hospital in Rabat over a period of 30 years (1993 to 2023). Included in the study are all patients with ADPKD meeting the ultrasound diagnostic criteria. The analysis focused on demographic, clinical, paraclinical, evolutionary data, as well as prognostic factors associated with renal function deterioration. Results: The mean age of patients at diagnosis is 51.53 +/− 17 years [16 - 93] with a male predominance. The median serum creatinine at diagnosis is 15.5 mg/l [10 - 34]. 21% of patients had ESRD (eGFR 300 mg/24h (21%). The most common cystic complication is hemorrhage (12.3%). 21.3% of patients had hepatorenal polycystic disease. In adjusted analysis, the predictive risk factors for the occurrence of ESRD were smoking (p = 0.019), anemia (p Conclusion: ADPKD can progress insidiously to ESRD. Identification and early treatment of predictive factors for poor renal prognosis could contribute to a better outcome for this disease.展开更多
Waste management is crucial due to the fast increase of human population, causing an increase in solid waste generation which if not properly managed causes environmental problems. Around 57% of the wastes generated f...Waste management is crucial due to the fast increase of human population, causing an increase in solid waste generation which if not properly managed causes environmental problems. Around 57% of the wastes generated from homes are made up of green material (fruits, vegetables…). Thus, reusing and recycling green wastes through composting is one way of reducing the waste load to landfills. Composting is the transformation of raw organic materials into organic soil amendments that provide nutrients to crops and enhance the tilth, fertility, and productivity of soils. Aerobic windrow composting system at Sukomi Greensite facility located at Karantina is performed, where materials biodegrade under controlled conditions to produce compost. However, assessment of the quality of the compost is fundamental in order to determine its usages. Thus, regular testing of physical, chemical and biological parameters was performed for adequate monitoring purposes. The basic objective of this study was to determine the characteristics of the Lebanese municipal solid waste compost on a yearly basis and compare these characteristics amongst the years. Hence, each parameter was tested and compared to the BNQ international Canadian standards for proper classification of the compost and adequate identification of its usages. The preliminary data obtained were statistically diagnosed through principal component analysis by Spadv55 software. All the data reflected the normal content value of the studied parameters with minor differences between the years except for year 2007 which demonstrated higher levels of Potassium, Phosphate, Lead and Cadmium. The characteristics of the compost enabled it to be used as a soil amendment on all types of agricultural and landscape commodities at the adequate dosages and proper timing. This data will additionally reflect the efficiency of the solid waste management practices adopted via highlighting the importance of the implementation of the integrated solid waste management practices.展开更多
Thoracic diseases pose significant risks to an individual's chest health and are among the most perilous medical diseases. They can impact either one or both lungs, which leads to a severe impairment of a person’...Thoracic diseases pose significant risks to an individual's chest health and are among the most perilous medical diseases. They can impact either one or both lungs, which leads to a severe impairment of a person’s ability to breathe normally. Some notable examples of such diseases encompass pneumonia, lung cancer, coronavirus disease 2019 (COVID-19), tuberculosis, and chronic obstructive pulmonary disease (COPD). Consequently, early and precise detection of these diseases is paramount during the diagnostic process. Traditionally, the primary methods employed for the detection involve the use of X-ray imaging or computed tomography (CT) scans. Nevertheless, due to the scarcity of proficient radiologists and the inherent similarities between these diseases, the accuracy of detection can be compromised, leading to imprecise or erroneous results. To address this challenge, scientists have turned to computer-based solutions, aiming for swift and accurate diagnoses. The primary objective of this study is to develop two machine learning models, utilizing single-task and multi-task learning frameworks, to enhance classification accuracy. Within the multi-task learning architecture, two principal approaches exist soft parameter sharing and hard parameter sharing. Consequently, this research adopts a multi-task deep learning approach that leverages CNNs to achieve improved classification performance for the specified tasks. These tasks, focusing on pneumonia and COVID-19, are processed and learned simultaneously within a multi-task model. To assess the effectiveness of the trained model, it is rigorously validated using three different real-world datasets for training and testing.展开更多
文摘目的探讨中性粒细胞CD64、C反应蛋白(CRP)、降钙素原(PCT)及中性粒细胞与淋巴细胞比值(NLR)在儿童社区获得性肺炎(CAP)中的诊断价值。方法选取海口市人民医院收治的CAP患儿186例,依据病原体不同分为细菌性肺炎组(95例),支原体肺炎组(43例)和病毒性肺炎组(48例)。细菌性肺炎患儿依据入院病情严重程度分为轻症组(75例)和重症组(20例)。采用流式细胞术检测外周血中性粒细胞CD64的表达,同时检测CRP、PCT及NLR水平。应用ROC曲线分析CD64、CRP、PCT及NLR水平对细菌性肺炎的诊断价值。结果细菌性肺炎组治疗前CD64(8.85±3.40 vs 2.26±0.74,2.42±0.95,2.38±0.80)、CRP(38.62±8.50 vs 3.25±0.96,3.42±1.15,4.16±1.53,mg/L)、PCT(6.17±1.40 vs 0.15±0.03,0.34±0.12,0.62±0.28,ng/mL)及NLR(7.84±3.25 vs 2.05±0.96,1.37±0.62,2.48±1.16)水平均明显高于对照组、病毒性肺炎组和支原体肺炎组(P<0.01)。细菌性肺炎患儿治疗后CD64(2.70±1.06 vs 8.85±3.40)、CRP(4.63±1.58 vs 38.62±8.50,mg/L)、PCT(0.21±0.06 vs 6.17±1.40,ng/mL)及NLR(2.28±1.07 vs 7.84±3.25)水平均明显低于治疗前(P<0.01)。重症细菌性肺炎患儿CD64(10.42±4.36 vs 7.60±2.58)、CRP(43.25±10.47 vs 34.85±8.16,mg/L)、PCT(9.26±2.18 vs 4.62±1.15,ng/mL)及NLR(9.75±4.12 vs 6.53±2.90)水平均明显高于轻症细菌性肺炎(P<0.01)。ROC曲线分析显示,CD64、CRP、PCT及NLR单项指标诊断细菌性肺炎的最佳截值分别为3.25、14.80 mg/L、1.83 ng/mL、4.37,四项联合诊断细菌性肺炎的AUC(0.948,95%CI:0.887~0.992)最大,其敏感度和特异度为96.2%和89.3%。Pearson相关分析显示,细菌性肺炎患儿CD64与CRP、PCT及NLR呈正相关(r=0.573、0.729、0.536,P<0.01),CRP与PCT及NLR呈正相关(r=0.602、0.497,P<0.01),PCT与NLR呈正相关(r=0.514,P<0.01)。结论CD64、CRP、PCT及NLR四项联合检测有助于提高细菌性肺炎的诊断价值,并可作为判断CAP患儿病情严重程度的实验室指标。
文摘Diabetic retinopathy(DR) is the most feared ocular manifestation of diabetes. DR is characterized by progressive retinal damage that may eventually result in blindness. Clinically, this blindness is caused by progressive damage to the retinal microvasculature, which leads to ischemia, retinal swelling, and neovascularization. Retinopathy is associated with both type 1 and type 2 diabetes, with DR being the leading cause of new onset blindness in United States adults. Despite this strong association with diabetes, it must be noted that the development of retinopathy lesions is multifactorial and may occur in individuals without an established history of diabetes. Metabolic syndrome is a multifactorial condition of central obesity, hypertriglyceridemia, dyslipidemia, hypertension, fasting hyperglycemia, and insulin resistance. Although several studies examined the individual components observed in the metabolic syndrome in relation to the development of DR, there is conflicting data as to the association of the metabolic syndrome with the development of retinopathy lesions in nondiabetic subjects. This review will summarize the current literature on the evidence of the metabolic syndrome on retinopathy in subjects with and without an established history of diabetes. This review will also discuss some of the mechanisms through which metabolic syndrome can contribute to the development of retinopathy.
文摘Mucinous cystadenoma of the appendix is a rare condition and represents one of the three entities with the common name mucocele of the appendix. It is characterized by a cystic dilatation of the lumen with stasis of mucus inside it. Histopathologically mucocele is divided into three groups： focal or diffuse mucosal hyperplasia, mucinous cystadenoma and mucinous cystadenocarcinoma. This condition is often associated with other neoplasia, especially adenocarcinoma of the colon and ovaries. We here describe a 57 year old male patient who presented with abdominal discomfort, constipation, fresh blood in stool and frequent urination. He had a big cystadenoma of the appendix associated with adenocarcinoma of the colon and hepatocellular carcinoma of the liver. The patient underwent right haemicolectomy, sigmoid colon resection and segmental resection of the liven Now 3 years later he has no evidence of disease relapse. According to this, we stress the need of accurate preoperative diagnosis and intraoperative exploration of the whole abdomen in these patients.
文摘A 90-day experiment was conducted to investigate the effects of different dietary linoleic acid （LA; 18：2n-6） and linolenic acid ratios （LNA; 18：3n-3） on growth induces, feed utilization and tissue fatty acid profile of freshwater prawn, Macrobrachium rosenbergii post-larvae （PL）. The experiment was conducted in cubic indoor fiberglass tanks, each holding 700 L in triplicate. Post-larvae with an average weight of 20.8 ± 0.20 mg were stocked at 80 PL m2. Five experimental isocaloric （15.06 MJ kgl digestible energy）, and isonitrogenous （30.45% digestible protein） diets were formulated by blending of soybean oil and linseed oil to containing five dietary LA/LNA ratios （7.80, 2.75, 1.28, 0.65 and 0.30）. The highest survival values were recorded for prawn PL fed diet containing 0.65 LA/LAN ratios. Growth indices of PL significantly increased （P 〈 0.05） with decreased dietary LA/LAN ratios to 0.65. The same trend was observed for the highest （P ≤ 0.05） protein efficiency ratio, protein productive value, fat retention, energy retention and best feed conversion ratio. The total whole tissue polyunsaturated fatty acid composition of M. rosenbergii PL was dominated by LA followed by LAN. Post larvae fed the diets containing higher LA/LNA ratios showed a higher tissue LA/LNA ratio. The obtained findings revealed that fatty acid patterns ofM. rosenbergii PL were influenced by fatty acid profiles of diets. The diet containing 0.65 LA/LNA ratio is recommended to obtaining optimum growth performance and feed utilization for M. rosenbergii PL.
基金Supported by Swiss Science Foundation,No.SCOPES,IZ73Z0_152407
文摘Immune reactivity and chronic low-grade inflammation(metaflammation) play an important role in the pathogenesis of obesity-associated metabolic disorders, including type 2 diabetes and nonalcoholic fatty liver disease(NAFLD), a spectrum of diseases that include liver steatosis, nonalcoholic steatohepatitis(NASH), fibrosis, and cirrhosis. Increased adiposity and insulin resistance contribute to the progression from hepatic steatosis to NASH and fibrosis through the development of proinflammatory and profibrotic processes in the liver, including increased hepatic infiltration of innate and adaptive immune cells, altered balance of cytokines and chemokines, increased reactive oxygen species generation and hepatocellular death. Experimental models of dietary-induced NAFLD/NASH in mice on different genetic backgrounds or knockout mice with different immune reactivity are used for elucidating the pathogenesis of NASH and liver fibrosis. Galectin-3(Gal-3), a unique chimera-type β-galactoside-binding protein of the galectin family has a regulatory role in immunometabolism and fibrogenesis. Mice deficient in Gal-3 develop pronounced adiposity, hyperglycemia and hepatic steatosis, as well as attenuated liver inflammation and fibrosis when fed an obesogenic high-fat diet. Interleukin(IL)-33, a member of the IL-1 cytokine family, mediates its effects through the ST receptor, which is present on immune and nonimmune cells and participates in immunometabolic and fibrotic disorders. Recent evidence, including our own data, suggests a protective role for the IL-33/IL-33R(ST2) signaling pathway in obesity, adipose tissue inflammation and atherosclerosis, but a profibrotic role in NASH development. The link between Gal-3 and soluble ST2 in myocardial fibrosis and heart failure progression has been demonstrated and we have recently shown that Gal-3 and the IL-33/ST2 pathway interact and both have a profibrotic role in diet-induced NASH. This review discusses the current evidence on the roles of Gal-3 and the IL-33/ST2 pathway and
基金supported by National Natural Science Foundation of China (Grant No. 10471084)
文摘Let (X, ρ) be a metric space and ↓USCC(X) and ↓CC(X) be the families of the regions below all upper semi-continuous compact-supported maps and below all continuous compact-supported maps from X to I = [0,1], respectively. With the Hausdorff-metric, they are topological spaces. In this paper, we prove that, if X is an infinite compact metric space with a dense set of isolated points, then (↓USCC(X), ↓CC(X)) ≈ (Q, c 0 ∪ (Q Σ)), i.e., there is a homeomorphism h:↓USCC(X) → Q such that h(↓CC(X)) = c 0 ∪ (Q Σ), where Q = [?1,1]ω, Σ = {(x n ) n∈? ∈ Q: sup|x n | < 1} and c 0 = {(x n ) n∈? ∈ Σ: lim n→+∞ x n = 0}. Combining this statement with a result in our previous paper, we have $$ ( \downarrow USCC(X), \downarrow CC(X)) \approx \left\{ \begin{gathered} (Q,c_0 \cup (Q\backslash \Sigma )), if the set of isolanted points is dense in X, \hfill \\ (Q,c_0 ),otherwise, \hfill \\ \end{gathered} \right. $$ if X is an infinite compact metric space. We also prove that, for a metric space X, (↓USCC(X), ↓CC(X)) ≈ (Σ, c 0) if and only if X is non-compact, locally compact, non-discrete and separable.
基金Supported by Ministry of Science, Project No. 145061
文摘AIM: To determine clinical characteristics and treatment outcome of gastric lymphoma after chemotherapy and immuno-chemotherapy. METHODS: Thirty four patients with primary gastric mucosa associated lymphoid tissue (MALT) lymphoma (Ann Arbor stages Ⅰ to Ⅳ) were enrolled. All had upper gastric endoscopy, abdominal ultrasonography, CT and H pylori status assessment (histology and serology). After anti-H pylori treatment and initial chemotherapy, patients were re-examined every 4 mo. RESULTS: Histological regression of the lymphoma was complete in 22/34 (64.7%) and partial in 9 (26.5%) patients. Median follow up time for these 31 responders was 60 mo (range 48-120). No regression was noted in 3 patients. Among the 25 (73.5%) H pylori positive patients, the eradication rate was 100%.CONCLUSION: Using univariate analysis, predictive factors for overall survival were international prognostic index (IPI) score, hemoglobin level, erythrocyte sedimentation rate (ESR), and platelet numbers (P < 0.005). In addition to this, Cox proportion hazard model differentiate IPI score, ESR, and platelets as predictors of survival.
文摘AIM To investigate the effect of adipose-derived mesenchymal stem cells(ADMSCs)and their conditioned media(CM) on hepatocellular carcinoma(HCC) cell tumorigenesis.METHODS The proliferation rate of HepG2 and PLC-PRF-5 HCC cancer cells was measured using the trypan blue exclusion method and confirmed using the cell-counting kit8(commonly known as CCK-8) assay. Apoptosis was detected by flow cytometry using annexin V-FITC. Protein and mRNA expression was quantified by ELISA and real time PCR, respectively. Migration and invasion rates were performed by Transwell migration and invasion assays. Wound healing was examined to confirm the data obtained from the migration assays.RESULTS Our data demonstrated that when co-culturing HCC cell lines with ADMSCs or treating them with ADMSC CM, the HCC cell proliferation rate was significantly inhibited and the apoptosis rate increased. The decreased proliferation rate was accompanied by an upregulation of P53 and Retinoblastoma mRNA and a downregulation of c-Myc and hTERT mRNA levels. More notably, ADMSCs and their CM suppressed the expression of the two important markers of HCC carcinogenicity, alpha-fetoprotein and Des-gamma-carboxyprothrombin. In addition, the migration and invasion levels of HepG2 and PLC-PRF-5 cells significantly decreased, potentially through increased expression of the tissue inhibitor metalloproteinases TIMP-1, TIMP-2 and TIMP-3.CONCLUSION These findings shed new light on a protective and therapeutic role for ADMSCs and their CM in controlling HCC invasiveness and carcinogenesis.
基金Rosoideae genome research and comparative genomics at FEM are supported by the research office of the Provincia autonoma di Trento
文摘The Rosoideae is a subfamily of the Rosaceae that contains a number of species of economic importance,including the soft fruit species strawberry(Fragaria 3ananassa),red(Rubus idaeus)and black(Rubus occidentalis)raspberries,blackberries(Rubus spp.)and one of the most economically important cut flower genera,the roses(Rosa spp.).Molecular genetics and genomics resources for the Rosoideae have developed rapidly over the past two decades,beginning with the development and application of a number of molecular marker types including restriction fragment length polymorphisms,amplified fragment length polymorphisms and microsatellites,and culminating in the recent publication of the genome sequence of the woodland strawberry,Fragaria vesca,and the development of high throughput single nucleotide polymorphism(SNP)-genotyping resources for Fragaria,Rosa and Rubus.These tools have been used to identify genes and other functional elements that control traits of economic importance,to study the evolution of plant genome structure within the subfamily,and are beginning to facilitate genomic-assisted breeding through the development and deployment of markers linked to traits such as aspects of fruit quality,disease resistance and the timing of flowering.In this review,we report on the developments that have been made over the last 20 years in the field of molecular genetics and structural genomics within the Rosoideae,comment on how the knowledge gained will improve the efficiency of cultivar development and discuss how these advances will enhance our understanding of the biological processes determining agronomically important traits in all Rosoideae species.
基金Gastrointestinal Research Laboratory,Department of Medicine,University of Rostock,Germany
文摘AIM:This paper describes the procedure of detection of Helicobacter pylori(H.pylori)in bile specimens in patients suffering from benign diseases of biliary ducts(lithiasis with/without nonspecific cholangitis). METHODS:The group of 72 patients entering the study consisted of 32 male and 40 female(45 % and 55 %, respectively).Bile was obtained during ERCP in 68 patients, and during cholecystectomy in 4 patients.A fast urease test (FUT)to determine the existence of H.pylori in gastric mucosa was carried out for all the patients during the endoscopic examination.The existence of genetic material of H.pylori was determined by detection of ure A gene by the method of nested PCR.The results of this reaction were shown by electrophoresis on 10 g·L^(-1)agarose gel in a band of 256 bp. RESULTS:The majority of the patients included in our study had biliary lithiasis without signs of cholangitis(48 patients, 67 %),whereas other patients were complicated by cholangitis(17 patients,24 %).Seven patients(9 %)had normal ERCP,forming thus the control group.In the group of patients with lithiasis 26 patients(24.2 %)had positive PCR of H.pylori in bile and among the patients with associated cholangitis positive PCR was detected in 9 patients(52.9 %).Among the seven patients with normal ERCP only one(14 %)had positive PCR of H.pylori.A high percentage of H.pylori infection of gastric mucosa was observed(57 patients,79 %).It was also observed that its slightly higher positivity was in the patients with distinct bile pathology:81% FLIT positive patients in the group with choledocholithiasis alone and 76 % in the group with choledocholithiasis associated with cholangitis.Seventy-one percent of the patients with regular findings had positive FUT.CONCLUSION: The prevalence of H. pylori infection both in bile and in gastric mucosa in patients with benign diseases of biliary ducts does not show a statistically significant difference in relation to the prevalence of the same with the patients with normal ERCP. The existence of H. pylori in
文摘Polymer electrolyte membrane(PEM)fuel cells are electrochemical devices that directly convert the chemical energy stored in fuel into electrical energy with a practical conversion efficiency as high as 65%.In the past years,significant progress has been made in PEM fuel cell commercialization.By 2019,there were over 19,000 fuel cell electric vehicles(FCEV)and 340 hydrogen refueling stations(HRF)in the U.S.(~8,000 and 44,respectively),Japan(~3,600 and 112,respectively),South Korea(~5,000 and 34,respectively),Europe(~2,500 and 140,respectively),and China(~110 and 12,respectively).Japan,South Korea,and China plan to build approximately 3,000 HRF stations by 2030.In 2019,Hyundai Nexo and Toyota Mirai accounted for approximately 63%and 32%of the total sales,with a driving range of 380 and 312 miles and a mile per gallon(MPGe)of 65 and 67,respectively.Fundamentals of PEM fuel cells play a crucial role in the technological advancement to improve fuel cell performance/durability and reduce cost.Several key aspects for fuel cell design,operational control,and material development,such as durability,electrocatalyst materials,water and thermal management,dynamic operation,and cold start,are briefly explained in this work.Machine learning and artificial intelligence(AI)have received increasing attention in material/energy development.This review also discusses their applications and potential in the development of fundamental knowledge and correlations,material selection and improvement,cell design and optimization,system control,power management,and monitoring of operation health for PEM fuel cells,along with main physics in PEM fuel cells for physics-informed machine learning.The objective of this review is three fold:(1)to present the most recent status of PEM fuel cell applications in the portable,stationary,and transportation sectors;(2)to describe the important fundamentals for the further advancement of fuel cell technology in terms of design and control optimization,cost reduction,and durability improvement;and(3)to
文摘Glanzmann thrombasthenia (GT) is a rare and often underdiagnosed congenital bleeding disorder caused by mutations in the genes encoding glycoproteins GPIIb or GPIIIa, resulting in platelet dysfunction. Inherited in an autosomal recessive manner, GT is characterized by the inability of platelets to aggregate. Clinically, it presents with mucocutaneous bleeding, such as easy and extensive bruising, severe epistaxis, menorrhagia, gingival bleeding, postpartum hemorrhage, and unexpected bleeding following procedures, despite a normal platelet count. We present a case involving a 6-year-old male patient who experienced spontaneous gingival bleeding for the past 4 weeks due to the eruption of his first permanent molars. The bleeding was particularly severe at night, disrupting the child’s sleep. The patient had been diagnosed with GT at the age of 16 months. Dental management was pursued, and the use of tranexamic acid mouthwash, combined with meticulous oral hygiene, resulted in an excellent response.
文摘Introduction: Primary hyperoxaluria type 1 (HP1) is a rare lithiasis with systemic involvement, due to the accumulation of calcium oxalate crystals. In the absence of therapeutic management, it progresses to end-stage chronic renal failure. The aim of this study is to describe and analyse the observations of our patients with HP1. Patients and methods: This is a retrospective study carried out between 2014 and 2023 in the Nephrology-Dialysis Transplant Department of the Ibn Sina University Hospital in Rabat. The clinical, paraclinical and evolutionary elements were taken from the patients’ medical records. Results: We collected 11 cases, with a mean age of 27 ± 8.5 years and a M/F sex ratio of 1.7. The diagnosis of HP1 was made on the basis of genetic analysis in 8 patients, morphological and spectro-photometric analysis of the calculus in one patient, biopsy of the graft in one patient and crystalluria and a family history of PH1 in one patient. Two patients died, and 8 patients were on chronic haemdialysis with systemic damage. Only one patient maintained a stable GFR at 60 ml/min. Conclusion: Early diagnosis combined with conservative treatment is the only way to limit the rapid progression of this disease. This requires awareness and collaboration between nephrologists, urologists and biologists within a specialised team.
文摘The treatment of hepatitis C has undergone a significant boom since the advent of direct acting antivirals (DAA). Indeed, the interferon-ribavirin combination that has been used to treat hepatitis C has a virological response in only 45% of cases with significant side effects. The advent of direct-acting antivirals has changed the prognosis of cirrhotic patients with hepatitis C. DAAs have ensured a sustained viral response in the majority of patients. Our work aims to see the evolution of hepatitis C patients at the cirrhosis stage under DAA. We conducted a retrospective study over 15 years (January 2009, January 2024) including all patients with post-viral cirrhosis C, whom we divided into two groups: group A, cirrhotic patients who received ribavirin and interferon, and group B, patients on DAA. From January 2009 to January 2024, we conducted a study of 182 patients with viral hepatitis C, including 102 cirrhotic patients. The mean age was 55 years. 66% of patients were initially treated with the ribavirin interferon combination, while 34% received direct-acting antivirals (DAAs). Since the introduction of DAAs, the most commonly used regimens have been sofosbuvir/daclatasvir with or without ribavirin and sofosbuvir/ledipasvir with or without ribavirin. Group A achieved sustained virological response (SVR) in 60% of cases, with notable side effects. In Group B, SVR was 98.18%, with improved tolerability and fewer side effects than previous treatments. Fifteen patients developed hepatocellular carcinoma (HCC), with a significantly lower mortality rate in those treated with DAAs compared with pegylated dual therapy (p: 0.001).
文摘Hypoxic hepatitis, also known as ischemic hepatitis, is characterized by acute hepatocellular injury due to inadequate oxygen delivery to the liver. Celiac trunk stenosis can lead to hepatic ischemia and subsequent liver damage. We present the case of an 81-year-old patient with a history of hypertension, ischemic heart disease, hypothyroidism, and biliary lithiasis, who developed hypoxic hepatitis secondary to Dunbar syndrome and a stenosis of the superior mesenteric artery. The patient improved symptoms and liver function tests with conservative management, including intravenous fluids and supportive care. Long-term management involved continued antiplatelet therapy and statins, with consideration of further interventions for celiac trunk stenosis. This case underscores the importance of recognizing Dunbar syndrome as well as superior mesentery trunk stenosis as a potential cause of hypoxic hepatitis. It highlights the need for multidisciplinary management in such cases.
文摘Background: Peripartum cardiomyopathy (PPCM) is a rare disease that typically affects young, healthy women. Because PPCM is associated with significant mortality, timely diagnosis and management are essential. Ventricular tachycardia (VT) is a major complication and contributor to sudden death. Available data on VT in patients with PPCM are limited. Aim: This case report demonstrates the clinical presentation, antenatal care, and management of labor and delivery in a patient with PPCM complicated by VT. Case report: 36-year old patient G4P3 presents at 27 weeks gestation to the emergency department complaining of chest tightness, palpitations, and profuse sweating. Peripartum cardiomyopathy was diagnosed after her last pregnancy a few years prior. Ventricular tachycardia was diagnosed at this visit and treated successfully. The remainder of the pregnancy was uneventful until she had another episode of ventricular tachycardia during labor. Treatment using antiarrhythmics (diltiazem, amiodarone, adenosine) highlights the importance of prompt intervention and the need for a range of therapeutic options. Results: This case demonstrated successful VT management during pregnancy and labor, emphasizing multidisciplinary collaboration, influencing maternal and fetal outcomes positively, providing insights into optimal care strategies. Conclusion: Peripartum cardiomyopathy complicated by ventricular tachycardia is a life-threatening combination. This case highlights the importance of timely diagnosis and management with combined care between cardiologists, maternal fetal medicine specialists and anesthesiologists to prevent morbidities and sudden maternal death.
文摘Introduction: Autosomal dominant polycystic kidney disease (ADPKD) is a common, multisystemic, and progressive hereditary disease. It accounts for 6 to 8% of incident cases of end-stage chronic renal disease (ESRD) in developed countries. The aim of this study is to describe the predictive factors for the development of end-stage chronic kidney disease (CKD) in the course of this disease. Material and Methods: This is a retrospective, descriptive, and analytical study including 300 cases of ADPKD collected at the Nephrology Department of Ibn-Sina Hospital in Rabat over a period of 30 years (1993 to 2023). Included in the study are all patients with ADPKD meeting the ultrasound diagnostic criteria. The analysis focused on demographic, clinical, paraclinical, evolutionary data, as well as prognostic factors associated with renal function deterioration. Results: The mean age of patients at diagnosis is 51.53 +/− 17 years [16 - 93] with a male predominance. The median serum creatinine at diagnosis is 15.5 mg/l [10 - 34]. 21% of patients had ESRD (eGFR 300 mg/24h (21%). The most common cystic complication is hemorrhage (12.3%). 21.3% of patients had hepatorenal polycystic disease. In adjusted analysis, the predictive risk factors for the occurrence of ESRD were smoking (p = 0.019), anemia (p Conclusion: ADPKD can progress insidiously to ESRD. Identification and early treatment of predictive factors for poor renal prognosis could contribute to a better outcome for this disease.
文摘Waste management is crucial due to the fast increase of human population, causing an increase in solid waste generation which if not properly managed causes environmental problems. Around 57% of the wastes generated from homes are made up of green material (fruits, vegetables…). Thus, reusing and recycling green wastes through composting is one way of reducing the waste load to landfills. Composting is the transformation of raw organic materials into organic soil amendments that provide nutrients to crops and enhance the tilth, fertility, and productivity of soils. Aerobic windrow composting system at Sukomi Greensite facility located at Karantina is performed, where materials biodegrade under controlled conditions to produce compost. However, assessment of the quality of the compost is fundamental in order to determine its usages. Thus, regular testing of physical, chemical and biological parameters was performed for adequate monitoring purposes. The basic objective of this study was to determine the characteristics of the Lebanese municipal solid waste compost on a yearly basis and compare these characteristics amongst the years. Hence, each parameter was tested and compared to the BNQ international Canadian standards for proper classification of the compost and adequate identification of its usages. The preliminary data obtained were statistically diagnosed through principal component analysis by Spadv55 software. All the data reflected the normal content value of the studied parameters with minor differences between the years except for year 2007 which demonstrated higher levels of Potassium, Phosphate, Lead and Cadmium. The characteristics of the compost enabled it to be used as a soil amendment on all types of agricultural and landscape commodities at the adequate dosages and proper timing. This data will additionally reflect the efficiency of the solid waste management practices adopted via highlighting the importance of the implementation of the integrated solid waste management practices.
文摘Thoracic diseases pose significant risks to an individual's chest health and are among the most perilous medical diseases. They can impact either one or both lungs, which leads to a severe impairment of a person’s ability to breathe normally. Some notable examples of such diseases encompass pneumonia, lung cancer, coronavirus disease 2019 (COVID-19), tuberculosis, and chronic obstructive pulmonary disease (COPD). Consequently, early and precise detection of these diseases is paramount during the diagnostic process. Traditionally, the primary methods employed for the detection involve the use of X-ray imaging or computed tomography (CT) scans. Nevertheless, due to the scarcity of proficient radiologists and the inherent similarities between these diseases, the accuracy of detection can be compromised, leading to imprecise or erroneous results. To address this challenge, scientists have turned to computer-based solutions, aiming for swift and accurate diagnoses. The primary objective of this study is to develop two machine learning models, utilizing single-task and multi-task learning frameworks, to enhance classification accuracy. Within the multi-task learning architecture, two principal approaches exist soft parameter sharing and hard parameter sharing. Consequently, this research adopts a multi-task deep learning approach that leverages CNNs to achieve improved classification performance for the specified tasks. These tasks, focusing on pneumonia and COVID-19, are processed and learned simultaneously within a multi-task model. To assess the effectiveness of the trained model, it is rigorously validated using three different real-world datasets for training and testing.
