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Patellar fractures in children

Published on: 19th November, 2019

OCLC Number/Unique Identifier: 9269418298

We describe a rare case of patellar fracture in a seven year old girl. The case was reviewed for various aspects such as clinical diagnosis, imaging tests and most suitable treatment.
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Treatment of autoimmune hemolytic anemia with erythropoietin: A case report

Published on: 20th November, 2019

OCLC Number/Unique Identifier: 9269420484

In this article, we describe the case of a fifty-year-old patient with autoimmune hemolytic anemia (AIHA) with constitutional symptoms, jaundice, unquantified fever and progressive dyspnea. The patient had history of smoking and Hepatitis A and following a physical exam she was found in a regular condition, icteric but with no other further signs. Her laboratory tests revealed hemolytic anemia with a hemoglobin of 8.5 g/dL, an increase of total and indirect bilirubin, an elevated ferritin, a decreased transferrin and haptoglobin and a positive result for direct Coomb’s test. Considering this, an immune profile was ordered finding a negative result of ANAs and ENAs and a decrease of complement C3 and C4. The patient was diagnosed with AIHA and as an initial step a corticosteroid treatment was administrated however the patient showed no clinical nor chemical improvement. At her third day of hospitalization, she was unstable hemodynamically requiring transfer to Intensive Care Unit (ICU) to optimize management. After 24 hours on ICU, due to persistence of deterioration of the patient, it was decided to manage with erythropoietin (EPO). In the following days, the patient showed a rise in her hemoglobin and an overall improvement made possible the transfer to hospitalization service. The AIHA is an uncommon disease and is not the first option that comes to mind with these symptoms, currently there are not controlled studies to the treatment due to its complexity and the heterogeneity of the results. We strongly support the use of EPO in refractory cases of this pathology.
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Foley catheter balloon tamponade as a method of controlling iatrogenic pulmonary artery bleeding in redo thoracic surgery

Published on: 20th November, 2019

OCLC Number/Unique Identifier: 9269426092

Background: Pulmonary artery bleeding secondary to iatrogenic injury is a troublesome intraoperative complication. The likelihood of encountering this complication is significantly higher in redo surgery for a number of reasons, including distortion of anatomical structures, adhesions and loss of tissue planes. Significant blood loss, although rare, remains a concern, and can occasionally be life-threatening. When significant bleeding from the pulmonary artery occurs, it can be a challenging situation to manage. Case Report: A 65 year old female was undergoing redo thoracic surgery in the setting of a completion lobectomy for biopsy-proven primary adenocarcinoma of the lung. Iatrogenic injury to the pulmonary artery resulted in significant bleeding that could not be managed by gaining proximal control due to dense adhesions. The novel decision to utilize a Foley catheter for balloon tamponade was taken, in order to provide sufficient haemostasis for definitive surgical repair of the defect to be undertaken Conclusion: The increased technical difficulties of redo thoracic surgery are well recognised. We describe the first case of Foley catheter balloon tamponade being utilized in the context of iatrogenic pulmonary artery bleeding during thoracic surgery.
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Delayed penile prosthesis implantation in the delayed presentation of ischemic priapism

Published on: 6th February, 2020

OCLC Number/Unique Identifier: 8541455754

Priapism is currently defined as a prolonged painful erection without sexual stimuli, if priapism persists > 36 hours, conservative treatment does not lead to detumescence. The most common etiologies are: medications into corpora cavernosa, anti-psychotics, anti-hypertensives, hematological disorders (chronic myeloid leukemia). The Penile prosthesis is the choice treatment for restoring the erectile function after the failure of the conservative treatment. But the corporal fibrosis makes it very difficult, with high risk of complications [1].
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Only low intensity of aerobic exercise improves respiratory compliance in pulmonary hypertensive rats

Published on: 20th November, 2019

OCLC Number/Unique Identifier: 8440622691

Objective: To investigate in an animal model of Pulmonary Hypertension (PH) by monocrotaline whether a lower exercise intensity, which has lower potential to provoke dyspnea symptoms, could prevent the increase the right ventricle pressure and the decrease in respiratory compliance. Setting: A research laboratory. ANIMALS: twenty-one Wistar rats were randomized to the groups: Control (CO; saline solution); PH-sedentary; PH-low and PH-moderate intensity of exercise training (ET). Interventions: They received a single saline or monocrotaline subcutaneous injection (50 mg/kg). The exercise program was performed during 3-weeks. Main Outcome Measures: Rats were evaluated by their morphometric and hemodynamic changes and by the respiratory mechanic responses induced by the exercise protocols. Results: Both protocols of ET significantly (p < 0.05) attenuated the increase in the right ventricular systolic pressure. However, the lower intensity was more effective to prevent the impairment in the respiratory and quasi-static compliance. Conclusion: Collectively, our results showed for the first time the benefits of ET to the respiratory system mechanics. We also demonstrated that intensity is crucial in PH, probably due to the difficulty to match VO2 capacity and O2 demand during exercise. The improvement in quasi-static compliance not only might improve the ability to breathe, and capture oxygen, but also welfare.
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Aortic dissection causing 2 myocardial infarctions

Published on: 16th December, 2019

OCLC Number/Unique Identifier: 8488779776

A 56-year-old man was admitted to our hospital because of sudden onset of right-sided thoracic pain. The ECG showed inferior ST segment elevations. He has been treated with aspirin, clopidogrel, unfractionated heparin and tenecteplase, and his symptoms resolved after 30 minutes. About half an hour later, the patient developed again left-sided thoracic pain and the signs of an anterior myocardial ST-segment elevation infarction. 90 minutes after receiving the initial medications, the performed coronary angiography revealed a long dissection of a large ramus circumflexus. Furthermore, the left anterior descending coronary artery was occluded at about the mid-level. The left ventriculography showed a reduced ventricular function and a Stanford type A aortic dissection. Immediate patient transfer for emergency surgical intervention was arranged. However, ventricular fibrillation occurred during transport and he required endotracheal intubation and prolonged cardiopulmonary resuscitation. Unfortunately, he died during further transport. In a patient with massive thoracic pain of initially uncommon localization in combination with fluctuation of ST-segment elevations, aortic dissection should be seriously taken into the differential diagnosis as well as into therapeutic management decisions (in particular antiplatelet and thrombolytic therapy).
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Factors Influencing Knowledge on the Completion of Treatment among Tuberculosis Patients under Directly Observed Treatment Strategy (DOTS) in a Selected Health Facility, the Bahamas

Published on: 25th March, 2024

Objective: To determine the factors influencing completion of DOTS in Tuberculosis treatment in the Bahamas.Methods: A quantitative, descriptive cross-sectional survey. Tuberculosis patients aged 18 years and above were considered regardless of the site or the smear status of their TB. The sample size was 40. Data analysis and interpretation were done using the statistical package for the social sciences software (SPSS version 24), through the exploration and calculation of descriptive (frequencies, percentages, means, standard deviations, and inferential (Anova) statistical methods. Statistical significance was determined to be a p < 0.05. Results: The mean age of the respondents, was 39.9 years, SD 11.65, and 73% of them were men. 63% of participants, 78% of whom were citizens of the Bahamas, reported having no annual income. Seventy-eight percent (31) of the participants said they had insufficient food and drink while they were unwell. More than half of the participants in the survey reported being on at least one pharmaceutical regimen, although 36% said they were not actively taking any of the prescription medications.Conclusion: Less than a third were noncompliant with DOTS, this was influenced by factors such as annual income, no family support, marital status, employment status, and educational level.
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Microbial Conversion and Utilization of CO2

Published on: 4th September, 2023

Rising greenhouse gas emissions have contributed to unprecedented levels of climate change, while microbial conversion and utilization of CO2 is a practical way to reduce emissions and promote green manufacturing. This article mainly summarizes several natural CO2 pathways that have been discovered, including the Calvin cycle, the reduced tricarboxylic acid (rTCA) cycle, the Wood–Ljungdahl (WL) pathway, the 3-hydroxypropionate/4-hydroxybutyrate (HP/HB) cycle, the dicarboxylate/4-hydroxybutyrate (DC/HB) cycle, the 3-hydroxypropionate (3HP) cycle, the reductive glycine (rGly) pathway, and artificially designed carbon fixation pathways includes the CETCH cycle, the MOG pathway, the acetyl-CoA bicycle, and the POAP cycle. We also discussed applications of different carbon fixation enzymes, notably ribulose-1, 5-diphosphate carboxylase/oxygenase, pyruvate carboxylase, carbonic anhydrase, as well as formate dehydrogenase. This paper further addressed the development of photosynthetic autotrophs, chemergic autotrophs and model bacteria Escherichia coli or yeast produced main products for CO2 fixation through metabolic engineering, such as alcohols, organic acids, fatty acids and lipids, bioplastics, terpenoids, hydrocarbons, and biomass.  Future studies on CO2 microbial conversion should focus on improving the efficiency of carbon fixation enzymes, metabolic modules of the carbon sequestration pathway, and intracellular energy utilization. Coupled microbial and electrochemical methods for CO2 fixation, in addition to biological fixation, show considerable promise. 
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Bioaccumulation of As, Cd, Cr, Cu, Pb, Zn in Ambrosia artemisiifolia L. in the polluted area by enterprise for the production and processing of batteries

Published on: 13th July, 2022

OCLC Number/Unique Identifier: 9575035815

In this paper, the concentration of As, Cd, Cr, Cu, Pb, and Zn was investigated in soil and Ambrosia artemisiifolia L. sampling from polluted cite near the enterprises for the production and processing of batteries in the city of Dnipro in Ukraine. The obtained results of the study were provided to assess the plant species through bio-monitoring and phytoremediation. Though Ambrosia artemisiifolia L. is a weed that causes serious allergic reactions in humans, this plant species can also have a high bioaccumulative capacity regarding metals. The obtained results highlighted the metals’ significantly higher concentration in roots than in the inflorescence part in Ambrosia artemisiifolia L. Among all studied metals, Zn and Cu had the highest concentration in Ambrosia artemisiifolia L., while lead was characterized by the highest bioavailable content available to plant forms in the soil. The various distribution of As, Cd, Cr, Cu, Pb, and Zn was found in different parts of the plant. According to plant-up-taking indexes studied elements can be ranked in the following descending order: Cu > Zn > Cr > Cd > Pb. Ambrosia artemisiifolia L. could be proposed for phytoremediation in Zn, Cu, Cd, and Cr contaminated soils although this species is resistant to lead soil pollution.
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Malignant transformation of an urachal cyst

Published on: 4th November, 2020

OCLC Number/Unique Identifier: 8873200457

A 27-year-old man presented to our hospital for abdominal pain and a cheesy discharge from the umbilicus which lasted for a few days. He was afebrile. The physical examination revealed periumbilical tenderness and discharge from the umbilicus. There were no signs of general infection. Otherwise, he had neither specific symptoms nor a palpable abdominal mass. Pelvic computerized tomographic (CT) scanning) confirmed the presence of a cyst in the midline of the abdominal wall, with communication with the bladder and peripheral calcification. The mass was infiltrated to the perivesical fat (Figure 1). The patient was prepared for surgery. During laparotomy, a urachal cyst with the cuff of the bladder dome were removed (Figure 2). Recovery was unremarkable. The resected specimen was a partial cystectomy specimen with perivesical fat and the median umbilical ligament
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