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BACKGROUND CONTEXT: Early fusion is crucial in interbody procedures to minimize mechanical complications resulting from delayed union, especially for patients with osteoporosis. Bone morphogenetic proteins (BMPs) are used in spinal fusion procedures; however, limited evaluation exists regarding time-to-fusion for BMP use, particularly in patients with osteoporosis. PURPOSE: To evaluate the difference in time-to-fusion after single-level transforaminal lumbar interbody fusion (TLIF) surgery between recombinant human bone morphogenetic protein-2 (rhBMP-2) usage and nonusage groups according to bone density. STUDY DESIGN: Retrospective single-center cohort study. PATIENT SAMPLE: This study enrolled 132 patients (mean age, 65.25±8.66; male patients, 40.9%) who underwent single-level TLIF for degenerative disorders between February 2012 and December 2021, with pre and postoperative computed tomography (CT). OUTCOME MEASURE: The interbody fusion mass and bone graft status on postoperative CT scans was obtained annually, and time-to-fusion was recorded for each patient. METHODS: The patients were divided into 2 groups based on rhBMP-2 use during the interbody fusion procedure. Patients were further divided into osteoporosis, osteopenia, and normal groups based on preoperative L1 vertebral body attenuation values, using cutoffs of 90 and 120 Hounsfield units. It was strictly defined that fusion is considered complete when a trabecular bone bridge was formed, and therefore, the time-to-fusion was measured in years. Time-to-fusion was statistically compared between BMP group and non-BMP groups, followed by further comparison according to bone density. RESULTS: The time-to-fusion differed significantly between BMP and non-BMP groups, with half of the patients achieving fusion within 2.5 years in the BMP group compared with 4 years in the non-BMP group (p<.001). The fusion rate varied based on bone density, with the maximum difference observed in the osteoporosis group, when half of the patients achieved fusion within 3 years in the BMP group compared to 5 years in the non-BMP group (p<.001). Subgroup analysis was conducted, revealing no significant associations between time-to-fusion and factors known to influence the fusion process, including age, gender, medical history, smoking and alcohol use, and medication history, except for rh-BMP2 use and bone density. CONCLUSIONS: RhBMP-2 usage significantly reduced time-to-fusion in single-level TLIF, especially in patients with osteoporosis. LEVEL OF EVIDENCE: Level III.
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PURPOSE: To evaluate the actual change in clinical hip pain and hip migration after operation for non-ambulatory flaccid neuromuscular (NM) scoliosis and investigate whether there is an association between hip migration and coronal/sagittal pelvic tilt (CO-PT/SA-PT). PATIENTS AND METHODS: This retrospective, single-center, observational study evaluated a total of 134 patients with non-ambulatory flaccid neuromuscular scoliosis who underwent surgery performed by a single surgeon between 2003 and 2020, with at least 2 years of follow-up period. Operation procedures were conducted in two stages, beginning with L5-S1 anterior release followed by posterior fixation. Radiologic parameters were measured at preoperative, immediate postoperative, and last follow-up periods with clinical hip pain and clinical hip dislocation events. RESULTS: The significant improvements occurred in various parameters after correction surgery for NM scoliosis, containing Cobb's angle of major curve and CO-PT. However, Reimer's hip migration percentage (RMP) was increased on both side of hip (High side, 0.23 ± 0.16 to 0.28 ± 0.21; Low side, 0.20 ± 0.14 to 0.23 ± 0.18). Hip pain and dislocation events were also increased (Visual analog scale score, 2.5 ± 2.3 to 3.6 ± 2.6, P value < 0.05; dislocation, 6-12). Logistic regression analysis of the interactions between ΔRMP(High) and the change of sagittal pelvic tilt (ΔSA-PT) after correction reveals a significant negative association. (95% CI 1.003-1.045, P value = 0.0226). CONCLUSIONS: In cases of non-ambulatory flaccid NM scoliosis, clinical hip pain, and subluxation continued to deteriorate even after correction of CO-PT. There was a relationship between the decrease in SA-PT, and an increase in hip migration percentage on high side, indicating the aggravation of hip subluxation.
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Luxação do Quadril , Escoliose , Humanos , Escoliose/cirurgia , Feminino , Masculino , Estudos Retrospectivos , Adolescente , Luxação do Quadril/cirurgia , Luxação do Quadril/etiologia , Luxação do Quadril/diagnóstico por imagem , Criança , Fusão Vertebral/métodos , Adulto JovemRESUMO
STUDY DESIGN: Retrospective cohort study. OBJECTIVE: To compare the incidence of adjacent segmental pathology (ASP) following minimally invasive (MI) vs open transforaminal lumbar interbody fusion (TLIF) and to identify factors linked to ASP requiring reoperation. METHODS: This retrospective study reviewed the outcomes of patients who underwent MI-TLIF or open TLIF. Radiographic ASP (RASP) was evaluated using X-ray imaging to distinguish between degenerative changes, spondylolisthesis, and instability in the adjacent spinal segment. Clinical ASP (CASP) was assessed with the visual analog scale score for leg and back pain and the Oswestry disability index. Patient data were collected 1, 2, 5, and 10 years postoperatively. The timing and frequency of ASP reoperation were analyzed. RESULTS: Five years postoperatively, the RASP rate was 35.23% and 45.95% in the MI-TLIF and open TLIF groups. The frequency of CASP differed significantly between the MI-TLIF and open TLIF groups at 1 year postoperatively. The rates of RASP, CASP, and ASP necessitating reoperation were not significantly different 10 years postoperatively. Cranial facet violation significantly affected ASP in both groups. In the open TLIF group, preoperative adjacent segment disc degeneration significantly influenced ASP. CONCLUSION: The RASP rate at 5 years postoperatively and the CASP rate at 1 year postoperatively differed significantly between groups. There was no difference in the rate of ASP requiring reoperation. Cranial facet violation is a crucial driving factor for ASP after both surgical procedures.
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Vascular dementia (VD) is the second most prevalent dementia type, with no drugs approved for its treatment. Here, the effects of Banhabaekchulcheonma-Tang (BBCT) on ischemic brain injury and cognitive function impairment were investigated in a bilateral carotid artery stenosis (BCAS) mouse model. Mice were divided into sham-operated, BCAS control, L-BBCT (40 ml/kg), and H-BBCT (80 ml/kg) groups. BBCT's effects were characterized using the Y-maze test, novel object recognition test (NORT), immunofluorescence staining, RNA sequencing, and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway and Gene Ontology (GO) analyses. The NORT revealed cognitive function improvement in the H-BBCT group, while the Y-maze test revealed no significant difference among the four groups. The CD68+ microglia and GFAP+ astrocyte numbers were reduced in the H-BBCT group. Furthermore, H-BBCT treatment restored the dysregulation of gene expression caused by BCAS. The major BBCT targets were predicted to be cell division cycle protein 20 (CDC20), Epidermal growth factor (EGF), and tumor necrosis factor receptor-associated factor 1 (TRAF1). BBCT regulates the neuroactive ligand-receptor interaction and neuropeptide signaling pathways, as predicted by KEGG and GO analyses, respectively. BBCT significantly improved cognitive impairment in a BCAS mouse model by inhibiting microglial and astrocyte activation and regulating the expression of CDC20, EGF, TRAF1, and key proteins in the neuroactive ligand-receptor interaction and neuropeptide signaling pathways.
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Lesões Encefálicas , Isquemia Encefálica , Estenose das Carótidas , Disfunção Cognitiva , Neuropeptídeos , Animais , Camundongos , Estenose das Carótidas/complicações , Estenose das Carótidas/tratamento farmacológico , Fator de Crescimento Epidérmico/metabolismo , Ligantes , Fator 1 Associado a Receptor de TNF/metabolismo , Disfunção Cognitiva/tratamento farmacológico , Disfunção Cognitiva/etiologia , Cognição , Modelos Animais de Doenças , Neuropeptídeos/metabolismo , Camundongos Endogâmicos C57BLRESUMO
OBJECTIVE: This experiment was conducted to investigate the effect of grain-based pecking blocks on productivity and welfare status at two commercial broiler welfare-certified farms. METHODS: Production and welfare indicators were assessed at two farms (designated Farm A and B). Both farms had two windowless houses with forced tunnel-type ventilation and housed broilers at stocking densities of approximately 16.7 birds/m2 (Farm A) and 16.8 birds/m2 (Farm B). Each house was divided into two or three equal sections and was provided with or without pecking blocks. Grain-based pecking blocks, measuring 25 × 25 × 25 cm, were given to broilers in both farms at 1 block per 1,000 birds. Various parameters including productivity (body weight and flock uniformity), corticosterone levels (in fecal droppings and feathers), footpad dermatitis, hock burn, feather dirtiness, gait score, litter quality, body surface temperature, and volatile fatty acids in fecal samples were assessed at 26 days of age, whereas litter quality was analyzed at 13 and 26 days of age. RESULTS: There were no significant effects of providing pecking blocks on productivity (body weight and uniformity), fecal and feather corticosterone, welfare indicators (i.e., footpad dermatitis, hock burn, feather cleanliness, and gait score), and litter quality (i.e., moisture, nitrogen, and pH). No differences in body surface temperature between the control and enrichment treatments were noted in Farm B, but body surface temperatures of the head (p = 0.029) and legs (p = 0.011) in the enrichment vs. control group were elevated in Farm A. Butyrate concentration in the enrichment vs control group was higher in Farm B (p = 0.023), but this effect was not detected in Farm A. CONCLUSION: It is concluded that grain-based pecking blocks did not affect performance and welfare indicators. Further studies are warranted to elucidate the potential impact of grain-based pecking blocks on gut health indicators.
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The present study was conducted to assess the animal welfare status of broiler chickens raised in conventional and welfare-certified farms. One conventional farm (30,000 birds/house, 1,488 m2/house, 2 houses) and one animal welfare-certified farm (32,000 birds/house, 1,920 m2/house, 2 houses) were selected to measure productivity, stress responses, and animal welfare indicators in 3 broiler flocks (2 farms/season, n = 6 flocks/farm type) during summer, autumn, and spring. Upon farm visits, body weight, uniformity, and animal welfare indicators (i.e., fecal and feather corticosterone, footpad dermatitis, hock burn, feather dirtiness, and gait score) were measured at 26 d posthatch. Also, moisture, nitrogen, and pH of litter, light intensity, ammonia concentration, and body surface temperature of head, chest, and legs were measured. There was no difference in body weight and uniformity between farm types. Fecal corticosterone concentrations were higher (P = 0.021) in welfare-certified vs. conventional farm, but no significant difference was found in feather corticosterone. Welfare-certified vs. conventional farm had lower percentages of hock burn (P = 0.018), feather dirtiness scores (P = 0.009), and gait score (P = 0.040), and there was no difference in footpad dermatitis. Nitrogen content in litter samples tended to be higher in conventional vs. welfare-certified farms (P = 0.094), and there was no difference in moisture and pH between farm types. Ammonia concentration within the broiler houses was not different between 2 farms. However, animal welfare farm was found to be brighter than conventional farm (P < 0.001). The body surface temperature of head, chest, and legs was not different between farm types. In conclusion, the welfare-certified farm had higher welfare measures, including lower hock burn, feather dirtiness, and gait score, confirming an overall improvement in welfare indicators. However, the observation on the elevated feather corticosterone noted in welfare vs. conventionally raised chickens warrants further studies.
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Dermatite , Doenças das Aves Domésticas , Animais , Galinhas/fisiologia , Fazendas , Amônia , Corticosterona , Criação de Animais Domésticos , Bem-Estar do Animal , Peso Corporal , Dermatite/etiologia , Dermatite/veterinária , NitrogênioRESUMO
Military personnel in combat face a high risk of developing posttraumatic stress disorder (PTSD). In this study, a protocol-based scoping review was conducted to identify the current status of research on the efficacy of acupuncture for treating combat-related PTSD in military personnel. A literature search was conducted across 14 databases in November 2022, and data from the included studies were collected and descriptively analyzed. A total of eight studies were included. Participants were assessed for core PTSD symptoms using the PTSD Checklist for Diagnostic and Statistical Manual of Mental Disorders-5 and the Clinician-Administered PTSD Scale, as well as related symptoms, such as sleep issues. Although the efficacy of acupuncture has been substantiated in numerous studies, certain metrics did not exhibit improvement. Auricular acupuncture was the most commonly used treatment (50%) followed by manual acupuncture (25%) and a combination of both (25%). Shenmen and Kidney points were frequently targeted at auricular acupoints. The treatment period varied between 5 days and 2 months. While adverse events were reported in two of the fifty-five patients in the intervention group and in four of the sixty-four patients in the control group in the randomized controlled trial studies, no fatal adverse events were reported.
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OBJECTIVES: To compare the urine output and estimated glomerular filtration rate (eGFR) of patients postoperatively administered sugammadex or glycopyrrolate 7 days following kidney transplantation (KT). METHODS: We retrospectively enrolled 134 consecutive patients who underwent KT under general anesthesia. Their urine output and eGFR were recorded every 24 hours between postoperative day (POD) 1 and 7. We used regression analysis to evaluate the relationship between the reversal agent administered and the outcomes of the participants. RESULTS: The urine output and eGFR of the participants did not differ between the two groups. Multivariate analysis showed that body mass index (BMI) (odds ratio (OR) 1.21; 95% confidence interval (CI) 1.05-1.40), diabetes mellitus (OR 3.14; 95% CI 1.07-9.16), neurovascular disease (OR 7.00; 95% CI 1.61-30.42), and the duration of surgery (OR 1.01; 95% CI 1.00-1.01) were associated with lower urine output on POD 7. In addition, only BMI (OR 1.25; 95% CI 1.09-1.42) was associated with low eGFR on POD 7. CONCLUSIONS: The urine output and eGFR of patients administered sugammadex or glycopyrrolate following KT did not differ 7 days later. Moreover, glycopyrrolate does not affect urine output or eGFR on POD 7, according to multivariate regression analysis.
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Glicopirrolato , Transplante de Rim , Humanos , Estudos Retrospectivos , Transplante de Rim/efeitos adversos , Sugammadex , Taxa de Filtração Glomerular , RimRESUMO
Major depressive disorder (MDD) is a medical condition involving persistent sadness and loss of interest; however, conventional treatments with antidepressants and cognitive behavioral therapy have limitations. Based on the pathogenesis of MDD, treatments using herbal medicines (HM) have been identified in animal studies. We conducted a systematic review of clinical studies to identify neurobiological outcomes and evaluate the effectiveness of HM in treating MDD. A meta-analysis was performed by searching nine databases from their inception until 12 September 2022, including 31 randomized controlled trials with 3133 participants, to examine the effects of HM on MDD using neurobiological biomarkers and a depression questionnaire scale. Quality assessment was performed using a risk of bias tool. Compared to antidepressants alone, HM combined with an antidepressant significantly increased concentrations of serotonin (SMD = 1.96, 95% CI: 1.24-2.68, p < 0.00001, I2 = 97%), brain-derived neurotrophic factor (SMD = 1.38, 95% CI: 0.92-1.83, p < 0.00001, I2 = 91%), and nerve growth factors (SMD = 2.38, 95% CI: 0.67-4.10, p = 0.006, I2 = 96%), and decreased cortisol concentrations (SMD = -3.78, 95% CI: -4.71 to -2.86, p < 0.00001, I2 = 87%). Although HM or HM with an antidepressant benefits MDD treatment through improving neuroendocrine factors, these findings should be interpreted with caution because of the low methodological quality and clinical heterogeneity of the included studies.
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Recently, we introduced a current limiter-based novel transcranial direct-current stimulation (tDCS) device that does not generate significant tDCS-induced electrical artifacts, thereby facilitating simultaneous electroencephalography (EEG) measurement during tDCS application. In this study, we investigated the neuromodulatory effect of the tDCS device using resting-state EEG data measured during tDCS application in terms of EEG power spectral densities (PSD) and brain network indices (clustering coefficient and path length). Resting-state EEG data were recorded from 10 healthy subjects during both eyes-open (EO) and eyes-closed (EC) states for each of five different conditions (baseline, sham, post-sham, tDCS, and post-tDCS). In the tDCS condition, tDCS was applied for 12 min with a current intensity of 1.5 mA, whereas tDCS was applied only for the first 30 s in the sham condition. EEG PSD and brain network indices were computed for the alpha frequency band most closely associated with resting-state EEG. Both alpha PSD and network indices were found to significantly increase during and after tDCS application compared to those of the baseline condition in the EO state, but not in the EC state owing to the ceiling effect. Our results demonstrate the neuromodulatory effect of the tDCS device that does not generate significant tDCS-induced electrical artifacts, thereby allowing simultaneous measurement of electrical brain activity. We expect our novel tDCS device to be practically useful in exploring the impact of tDCS on neuromodulation more precisely using ongoing EEG data simultaneously measured during tDCS application.
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Collagen peptides are widely employed as therapeutic materials due to their numerous beneficial properties, including for the following uses: antiaging, antioxidant applications, antibacterial applications, wound healing, tissue engineering, medication delivery, and cosmetics. Although collagen peptides are useful in these applications, to our knowledge, few published studies have been undertaken on their repeated-dose toxicity. We evaluated the possible subchronic toxicity of a collagen peptide derived from skate (Raja kenojei) skin (CPSS) in Sprague-Dawley rats by administering repeated oral doses over 90 days. Rats of both sexes were assigned randomly to one of four experimental groups, respectively receiving 0, 500, 1000, or 2000 mg/kg/day of CPSS. At all doses tested, repeated oral CPSS administration had no treatment-related adverse effects in terms of clinical signs, body weight, food consumption, detailed clinical observation, sensory reactivity, functional assessment, urinalysis, ophthalmic examination, gross pathology, hematology, serum biochemistry, hormone analysis, organ weight, and histopathology. Even though there were some alterations in hematologic parameters, serum biochemistry parameters, organ weight, and histopathological findings, these did not follow a dose-response pattern and were within historical limits for control rats. The oral no-observed-adverse-effect level (NOAEL) of the CPSS was 2000 mg/kg/day for both male and female rats in the applied experimental circumstances, and no target organs were identified.
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BACKGROUND: This scoping review aimed to determine the current research status of acupuncture for major psychiatric disorder (MPD) in earthquake survivors. METHOD: We followed the scoping review process described previously. A literature search on 14 electronic databases was conducted from inception to November 29, 2022. Data from the included studies were collected and descriptively analyzed to address our research question. Extracted data were collated, synthesized, and summarized the according to the analytical framework of a scoping review. RESULT: This scoping review included nine clinical studies: four randomized controlled trials (RCTs) and five before-after studies. The most frequent MPD type among the included acupuncture studies was posttraumatic stress disorder (PTSD; 6/9, 66.67%). The most frequent acupuncture type was scalp electro-acupuncture (4/9, 44.44%), followed by manual acupuncture and ear acupressure/ear acupuncture (3/9, 33.33%). Studies using scalp electro-acupuncture all used common acupoints, including GB20, GV20, GV24, and EX-HN1. In general, the treatment period lasted between 4 and 12 weeks. Validated assessment tools for PTSD severity and accompanying symptoms were used for patients with PTSD, while the corresponding evaluation tools were used for patients with other diagnoses or clinical symptoms. Acupuncture-related adverse events were generally mild and temporary, such as mild bleeding and hematoma, and syncope was a rare but potentially serious adverse event (1/48 patients and 1/864 sessions over a treatment period of 4 weeks). CONCLUSION: Acupuncture studies for MPD after an earthquake mainly focused on PTSD. RCTs accounted for around half of the included studies. Scalp electro-acupuncture was the most common acupuncture type, and EX-HN1 and GV24 were the most important acupoints in the acupuncture procedures for MPD. The included studies mostly used validated symptom assessment tools, though some did not. Clinical studies in this field need to be further expanded regardless of the study type. PROTOCOL REGISTRATION: https://osf.io/wfru7/.
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Terapia por Acupuntura , Terremotos , Transtornos de Estresse Pós-Traumáticos , Humanos , Terapia por Acupuntura/efeitos adversos , Terapia por Acupuntura/métodos , Transtornos de Estresse Pós-Traumáticos/terapia , Transtornos de Estresse Pós-Traumáticos/etiologiaRESUMO
BACKGROUND: and purpose: Banxia-Houpo-Tang (Banha-Hubak-Tang, BHT) is an East Asian traditional herbal medicine used for treating depression. Hence, this review aimed to provide reliable evidence on the efficacy and safety of BHT for depression. METHODS: Overall, 15 electronic databases were searched until July 31, 2022, and randomized controlled trials (RCTs) of BHT for depression were reviewed. The cochrane risk of bias tool version 2.0 was used for quality assessment. A meta-analysis was conducted to evaluate the efficacy and safety of BHT for depression. RESULTS: Fifteen RCTs (1,714 participants) were included. The pooled results suggested that the efficacy of BHT alone (standardized mean difference [SMD], -0.39; 95% confidence interval [CI], -0.79 to 0.00; P = 0.05) was similar to that of antidepressants alone in terms of the Hamilton depression scale (HAMD) scores. Their combination led to a more significant improvement in HAMD scores (SMD, -0.91; 95% CI, -1.21 to 0.60; P < 0.00001). Moreover, compared with antidepressants alone, BHT alone had a lower risk of causing adverse events, but the combination therapy exhibited a similar risk. No severe adverse events were reported. The overall risk of bias was high. The quality of evidence was very low to moderate. CONCLUSION: The study results indicate that BHT may be beneficial for treating depression. However, due to the clinical heterogeneity and low methodological quality of the included studies, the obtained findings should be interpreted with caution. Hence, further studies on this topic are warranted.
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Pinellia , Humanos , Depressão/terapia , Antidepressivos/efeitos adversos , Terapia CombinadaRESUMO
BACKGROUND: The combined anterior-posterior approach has shown good clinical outcomes for multilevel cervical diseases. This work describes the biomechanical advantage of cervical-pedicle-screw fixation over lateral-mass-screw fixation in combined anterior-posterior cases. METHOD: Seventy-six patients who received combined cervical surgery from June 2013 to December 2020 were included. The patients were divided into two groups: the lateral-mass-screw group (LMS) and the pedicle-screw group (PPS). Radiological outcomes were assessed with lateral cervical spine X-rays for evaluating sagittal alignment, subsidence, and bone remodeling. RESULTS: At 1 year postoperatively, the numbers of patients whose C2-C7 cervical lordosis was less than 20 degrees decreased by more in the PPS group (p-value = 0.001). The amount of vertical-length change from immediately to 1 year postsurgery was less in the PPS group than in the LMS group (p-value = 0.030). The mean vertebral-body-width change was larger in the PPS group than in the LMS group during 3 months to 1 year postsurgery (p-value = 0.000). CONCLUSIONS: In combined anterior-posterior cervical surgery cases, maintenance of cervical lordosis and protection of the vertebral body from subsidence were better with the pedicle-screw fixation. More bone remodeling occurred when using the pedicle-screw fixation method.
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Background: Yokenella regensburgei infections have been documented in several immunocompromised individuals with numerous associated risk factors including soft tissue infections, organ transplants, and metabolic disorders. Our report presents a rare case of Y. regensburgei infection in an immunocompetent individual. Methods: In September 2020, a 38-year-old man who was otherwise healthy fell from a personal conveyance causing a puncture of his elbow. Two months later, he was admitted to the hospital with a chronic draining wound on his left arm with no fever (36.7°C) and stable vital signs. The patient underwent white blood cell (WBC) imaging, and single-photon emission computed tomography (SPECT/CT) to rule out osteomyelitis. Incision and drainage were performed, and the collected fluid was sent to a microbiology lab for culture diagnosis. Subsequently, matrix-assisted laser desorption/ionization time-of-flight (MALDI-TOF) analysis and antimicrobial susceptibility testing were performed. Results: A WBC image and SPECT/CT test showed an increase in WBC uptake and activity in the subcutaneous tissue of the left arm. The culture diagnosis identified the isolate as Y. regensburgei and the patient received 2âweeks of sulfamethoxazole 800âmg and trimethoprim 160âmg orally twice daily based on the results of the antimicrobial susceptibility testing. He demonstrated clinical improvements shown through wound healing and reduced pain. Conclusion: This report supports the potential of Y. regensburgei to act as an opportunistic pathogen even in hosts with no prior underlying diseases or conditions.
Historique: Les infections à Yokenella regensburgei, qui ont été diagnostiquées chez plusieurs personnes immunodéprimées, sont associées à des facteurs de risque, y compris des infections des tissus mous, des transplantations d'organes et des troubles métaboliques. Le présent rapport expose un rare cas d'infection à Y. regensburgei chez une personne immunocompétente. Méthodologie: En septembre 2020, un homme de 38âans en bonne santé a subi une blessure ponctiforme sur le coude gauche à cause d'une chute en vélo de montagne. Deux mois plus tard, il a été hospitalisé en raison d'une plaie purulente chronique sur le bras gauche. Il ne faisait pas de fièvre (36,7°C), et ses signes vitaux étaient stables. Il a été soumis à une scintigraphie aux globules blancs et une tomographie par émission monophotonique pour écarter la possibilité d'ostéomyélite. Après une incision et un drainage, le liquide recueilli a été envoyé à un laboratoire de microbiologie pour poser un diagnostic par culture. Une analyse de la spectrométrie de masse à temps de vol selon la technique de désorption-ionisation laser assistée par matrice (MALDI-TOF) et un test de susceptibilité antimicrobienne ont ensuite été exécutés. Résultats: La scintigraphie aux globules blancs et la tomographie par émission monophotonique ont révélé une augmentation de la numération et de l'activité des globules blancs dans les tissus sous-cutanés du bras gauche. La culture a identifié que l'isolat était l'Y. regensburgei, et le patient a reçu un traitement de 800âmg de sulfaméthoxazole et de 160âmg de triméthoprime par voie orale deux fois par jour pendant deux semaines, en fonction du test de susceptibilité antimicrobienne. Son état clinique s'est amélioré, car sa plaie a guéri et sa douleur a diminué. Conclusion: Le présent rapport appuie la possibilité que l'infection à Y. regensburgei agisse comme agent pathogène opportuniste, même chez des hôtes sans maladie ou affection sous-jacente.
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Posttraumatic stress disorder is caused by traumatic events such as death, serious injury, and sexual violence. Military personnel and veterans are at high risk for posttraumatic stress disorder. Conventional posttraumatic stress disorder treatments have certain limitations. Complementary and integrative medicine treatments, especially acupuncture, are potential novel first-line treatments that may overcome these limitations. We aim to investigate the current status of the available clinical evidence related to acupuncture treatment for posttraumatic stress disorder in war veterans. We will follow the scoping review process as previously described. The study question is as follows: "Which types of clinical research designs, study types, study durations, adverse events, and clinical outcomes have been reported regarding acupuncture therapy for posttraumatic stress disorder in military veterans?" We will perform a comprehensive search of Medline, Excerpta Medica dataBASE, Cochrane Central Register of Controlled Trials, Web of Science, Scopus databases, Allied and Complementary Medicine Database, Cumulative Index to Nursing and Allied Health Literature, and PsycArticles databases, as well as Chinese, Korean, and Japanese databases, from inception to June 2022. Data from the included studies will be collected and descriptively analyzed in relation to our research question. The extracted data will be collated, synthesized, and summarized according to the analytical framework of a scoping review. The protocol of this study adheres to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews to ensure the clarity and completeness of our reporting in all phases of this scoping review (Protocol registration: https://osf.io/t723f/). The findings of this scoping review will provide fundamental data that will help researchers identify appropriate research questions and design further studies on the use of acupuncture for PTSD management in military veterans. These results will be helpful for developing disaster site-specific research protocols for future clinical trials on this topic.
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Terapia por Acupuntura , Militares , Transtornos de Estresse Pós-Traumáticos , Veteranos , Humanos , Terapia por Acupuntura/métodos , Literatura de Revisão como Assunto , Transtornos de Estresse Pós-Traumáticos/terapiaRESUMO
Earthquakes have the greatest destructive effect among all natural disasters. Posttraumatic stress disorder (PTSD), major depressive disorder (MDD), and anxiety disorder (AD) are major psychiatric disorders (MPD) that can be triggered by exposure to earthquakes. Conventional treatments such as pharmacological treatments have several limitations. Acupuncture therapy as a complementary integrative medicine may be an effective alternative treatment for these limitations. This study aimed to identify the status of the clinical evidence regarding acupuncture therapy for earthquake survivors with MPD. We will follow the scoping review process as previously described. The study question is as follows: "Which types of clinical research designs, study types, study durations, adverse events, and clinical outcomes have been reported regarding acupuncture therapy for MPD in earthquake survivors?" Medline, Excerpta Medica dataBASE, Cochrane Central Register of Controlled Trials, Web of Science, Scopus, Allied and Complementary Medicine Database, Cumulative Index to Nursing and Allied Health Literature, PsycArticles databases, and Chinese, Korean, and Japanese databases will be comprehensively searched electronically from their inception to November 2022. Data from the included studies will be collected and descriptively analyzed in relation to our research question. We will collate, synthesize, and summarize the extracted data according to the analytical framework of a scoping review. The protocol will conform with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extensions of Scoping Reviews to ensure the clarity and completeness of our reporting in the whole phase of the scoping review (Protocol registration: https://osf.io/wfru7/). The findings of this scoping review will provide fundamental data that will help researchers identify appropriate research questions and design further studies on the use of acupuncture for MPD management in earthquake survivors. These results will be helpful for developing disaster site-specific research protocols for future clinical trials on this topic.
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Terapia por Acupuntura , Transtorno Depressivo Maior , Desastres , Terremotos , Transtornos de Estresse Pós-Traumáticos , Humanos , Terapia por Acupuntura/métodos , Transtorno Depressivo Maior/terapia , Projetos de Pesquisa , Transtornos de Estresse Pós-Traumáticos/terapia , Transtornos de Estresse Pós-Traumáticos/psicologia , Revisões Sistemáticas como Assunto , Ensaios Clínicos Controlados como AssuntoRESUMO
Objective: Disasters adversely affect the mental health of disaster survivors, leading to depression, anxiety, and stress-related disorders. Survivors complain of not only psychological symptoms but also physical symptoms such as insomnia, pain, and fatigue. Providing immediate and effective psychological support to all survivors is difficult because human and physical medical resources are limited. Therefore, the authors developed a manual for disaster medical support using Korean medicine (KM) for disaster survivors to provide prompt, effective, and long-term support that supplement existing psychological support. Methods: In this article, the authors introduce KM treatment protocols, which are unique elements of the manual. In addition, the authors have developed a step-by-step treatment protocol based on the stage and condition of survivors, as well as separate treatment protocols for psychological and physical symptoms. Results: The interventions include ear acupuncture, acupuncture, herbal medicine, breathing relaxation, stabilization techniques, emotional freedom technique, and self-care methods such as acupressure, exercise, and walking meditation. This manual has been certified as an official procedure of the Korean Society of Oriental Neuropsychiatry. Conclusions: The authors believe that this manual will enable KM doctors to be effectively utilized as medical resources at disaster sites. Furthermore, this manual would provide a good model that can be extended to countries that wish to use integrative medicine for disaster support to implement the commitments of the Declaration of Astana.
Assuntos
Desastres , Transtornos de Estresse Pós-Traumáticos , Humanos , Transtornos de Estresse Pós-Traumáticos/terapia , Adaptação Psicológica , Sobreviventes/psicologia , República da CoreiaRESUMO
Facial emotion recognition (FER) systems are imperative in recent advanced artificial intelligence (AI) applications to realize better human-computer interactions. Most deep learning-based FER systems have issues with low accuracy and high resource requirements, especially when deployed on edge devices with limited computing resources and memory. To tackle these problems, a lightweight FER system, called Light-FER, is proposed in this paper, which is obtained from the Xception model through model compression. First, pruning is performed during the network training to remove the less important connections within the architecture of Xception. Second, the model is quantized to half-precision format, which could significantly reduce its memory consumption. Third, different deep learning compilers performing several advanced optimization techniques are benchmarked to further accelerate the inference speed of the FER system. Lastly, to experimentally demonstrate the objectives of the proposed system on edge devices, Light-FER is deployed on NVIDIA Jetson Nano.