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The use of marginal grafts is very challenging and is associated with post-reperfusion syndrome and early allograft dysfunction. The outcomes of machine perfusion for the preservation of marginal grafts have been compared with that of static cold storage, with studies reporting a reduced risk of ischemic cholangiopathy and graft loss. We performed this systematic review and meta-analysis of randomized controlled trials (RCTs) comparing outcomes of machine perfusion of liver grafts to static cold storage (SCS) of liver grafts during liver transplantation. Two independent researchers thoroughly searched for literature in the following databases: PubMed (Medline), Cochrane Central Register of Controlled Studies (CENTRAL), clinical trial registry, ResearchGate, Google Scholar, and Scopus (ELSEVIER) databases (last search: November 2023). The search terms used were: "dynamic perfusion," "normothermic perfusion," "hypothermic perfusion," "liver transplantation," "static cold storage," "NMP," "HOPE," "extended criteria grafts," "marginal grafts," "RCTs," "randomized controlled trials," "warm ischemia," and "cold ischemia." Eight RCTs published between 2019 and 2023 were included in the data synthesis and meta-analysis. The primary outcome considered was the overall incidence of early allograft dysfunction (EAD) between the two methods of graft perfusion after liver transplantation. The secondary outcome considered was the rate of retransplantation. Our meta-analysis revealed that SCS is associated with more EAD when compared with machine perfusion, with a p-value of <0.00001. We also found that the rate of retransplantation is higher among patients who received a liver preserved by SCS, with a p-value of 0.02. The use of machine perfusion in the preservation of liver grafts showed a significant reduction in early allograft dysfunction and retransplantation.
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Monkeypox virus (MPV) infection has developed into a re-emerging disease, and despite the potential of tecovirimat and cidofovir drugs, there is currently no conclusive treatment. The treatment's effectiveness and cost challenges motivate us to use In Silico approaches to seek natural compounds as candidate antiviral inhibitors. Using Maestro 11.5 in Schrodinger suite 2018, available natural molecules with validated chemical structures collected from Eximed Laboratory were subjected to molecular docking and ADMET analysis against the highly conserved A42R Profilin-like Protein of Monkeypox Virus Zaire-96-I-16 (PDB: 4QWO) with resolution of 1.52 Å solved 3D structure. Compared to the FDA-approved Tecovirimat, molecular docking revealed that Salsoline derivatives, Genistein, Semisynthetic derivative of kojic acid, and Naringenin had strengthened affinity (-8.9 to -10 kcal/mol) to 4QWO, and the molecular dynamic's simulation confirmed their high binding stability. In support of these results, the hydrogen bond analysis indicated that the Salsoline derivative had the most robust interaction with the binding pockets of 4QWO among the four molecules. Moreover, the comparative free energy analyses using MM-PBSA revealed an average binding free energy of the complexes of Salsoline derivative, Genistein, Semisynthetic derivative of kojic acid, Naringenin, of -106.418, -46.808, -50.770, and -63.319 kJ/mol, respectively which are lower than -33.855 kJ/mol of the Tecovirimat complex. Interestingly, these results and the ADMET predictions suggest that the four compounds are promising inhibitors of 4QWO, which agrees with previous results showing their antiviral activities against other viruses.
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Introduction. Assessment for learning or formative assessment plays a key role in improving student learning, allowing progress to be measured that contributes to the end of the semester generating summative assessments for the approval or disapproval of the semester. Objective. To analyze the perception of formative and summative evaluations in fourth-semester nursing students. Method. An observational, descriptive and cross-sectional study was carried out, the universe was constituted by 113 fourth-semester students, the sample constituted in a simple random way by 88 participants, with a confidence level of 95%; and a margin of error of 5%. The validated assessment preference inventory scale was used, structured by 69 items categorized into 3 dimensions. The statistical analysis of the data was done through descriptive statistics for the calculation of mean, standard deviations, frequencies and percentages using the SPSS version 25.0 program with an acquired license. Results. The age range of fourth-semester students ranges from 19 to 25 years old, and the predominant gender is female, in evaluation preferences students prefer multiple-choice evaluations and to a lesser extent written tests and oral exams. In the role and responsibility approach, they consider it feasible for the teacher to give a list of exam questions from which they can choose and consider having students perform the exam questions in lower weighting. Conclusions. The evaluations that the teacher performs directly are summative evaluations during the teaching and learning process in the training of nurses at a public university, and are related to the perceptions of the students, which denote the weaknesses in the formative evaluations that are essential to provide feedback on each activity that is taught, in order to identify learning gaps and provide positive feedback that allows contributing to the formation of the Theoretical and practical knowledge.
Introducción. La evaluación para el aprendizaje o evaluación formativa desempeña un papel clave en la mejora del aprendizaje de los estudiantes, permiten medir el progreso que contribuye a que al final del semestre se generen evaluaciones sumativas para la aprobación o desaprobación del semestre. Objetivo. Analizar la percepción de las evaluaciones formativas y sumativas en los estudiantes de cuarto de semestre de la carrera de enfermería. Método. Se realizó un estudio observacional, descriptivo y transversal, el universo estuvo constituido por 113 estudiantes de cuarto semestre, la muestra constituida de manera aleatoria simple por 88 participantes, con un nivel de confianza del 95%; y un margen de error del 5%. Se utilizó la escala validada inventario de preferencias de evaluación estructurada por 69 ítems categorizadas en 3 dimensiones. El análisis estadístico de los datos se hizo a través de estadística descriptiva para el cálculo de media, desviaciones estándar, frecuencias y porcentajes mediante la utilización del programa SPSS versión 25.0 con licencia adquirida. Resultados. El rango de edad de los estudiantes de cuarto semestre oscila 19 a 25 años, y el genero que predomina es el femenino, en las preferencias de evaluación los estudiantes prefieren las evaluaciones de opción múltiple y en menor direccionamiento las pruebas escritas y examen oral. En el enfoque de rol y responsabilidad consideran es factible que el docente de una lista de preguntas del examen entre las cuales puedan elegir y consideran hacer que los estudiantes realicen las preguntas del examen en menor ponderación. Conclusiones. Las evaluaciones que el docente realiza directamente son evaluaciones sumativas durante el proceso de enseñanza y aprendizaje en la formación de enfermeros de una universidad pública, y se relacionan con las percepciones de los estudiantes, que denotan las debilidades en las evaluaciones formativas que son fundamentales para retroalimentar cada actividad que se imparte, a fin de identificar brechas de aprendizaje y brindar Feedback positivo que permite contribuir a la formación del conocimiento teórico practico.
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Dermatophytic disease is a rare condition, primarily described in North Africa. This orphan disease owes its name to Hadida and Schousboe. Although the pathophysiology remains poorly understood, it is often associated with immune deficiency and occurs in the context of high consanguinity, as in our case. We report the case of a 24-year-old man who presented a trichophytic disease due to Trichophyton rubrum, admitted for the appearance of numerous subcutaneous nodules, prompting consultation at our institution. This dermatophytic disease typically begins with recurrent ringworm of the scalp or involvement of hairless skin. The dermatophytes involved are of anthropophilic and zoophilic origin, with T. violaceum being the most frequently isolated species in ringworm cases in the Maghreb. To date, no treatment regimen has been established. However, improving immune status and using antifungals have delayed or prevented the visceral dissemination of the disease.
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Inferior vena cava IVC is a crucial route for catheter access (both directly to the right heart and indirectly through a transeptal puncture to the left heart, used in most electrophysiological procedures). However, interrupted IVC is a real challenge to traditional arrythmia ablation approaches, compromising in certain cases the success of the procedure. A well-developed azygos continuation offers an alternative pathway, bypassing the interrupted segment of the IVC. We report the case of a 60 years old female, who underwent catheter ablation of a counterclockwise flutter. During the procedure, she was discovered to have an uncommon anatomical venous pathway from femoral access to the right heart chambers. She was diagnosed to have an interruption of the supra-renal segment of the inferior vena cava with azygos continuation. Radiofrequency ablation of the cavotricuspid isthmus was successfully performed through the azygos continuation.
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Multiple primary malignancies can occur as either synchronous or metachronous tumors, particularly in adults. Retroperitoneal liposarcoma is a rare malignancy arising from adipose tissue, while gastric adenocarcinoma is one of the most common neoplasms worldwide. The simultaneous occurrence of these 2 malignancies is extremely rare, with only 1 case reported worldwide. Here, we present the case of a 52-year-old man diagnosed with both retroperitoneal liposarcoma and gastric adenocarcinoma, marking the second reported case in the world.
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Cystic lymphangioma is a benign lymphatic malformation that primarily affects children, with rare occurrences in adults. These malformations are most commonly found in the head and neck region, though their presence in the abdominal cavity is infrequent. In this report, we present the case of 71-year-old women with a cystic lymphangioma located in the omental bursa. The rarity of this condition in adults, combined with its unusual abdominal location, highlights the unique aspects of this case. This report explores the clinical presentation, diagnostic challenges, and management strategies for these uncommon lymphatic malformations.
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Yolk sac tumors can occur in various extragonadal sites, including the hepatobiliary tract, and are often associated with elevated serum alpha-fetoprotein. We report the case of a 14-month-old male infant presenting with abdominal pain and distension. Ultrasound and computed tomography scans of the abdomen revealed contiguous hepatic masses with lobulated contours, containing areas of necrosis. The patient underwent surgical resection, and histological studies confirmed the diagnosis of a yolk sac tumor. The occurrence of a yolk sac tumor in the liver is extremely rare. Ultrasound and cross-sectional imaging can be highly effective in diagnosing these tumors when combined with biopsy procedures to confirm the diagnosis. Although rare, yolk sac tumors of the liver should be considered a differential diagnosis for hepatic masses.
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Background In general, rheumatologists often have limited knowledge regarding the use of complementary and alternative medicine (CAM) among patients with rheumatic diseases. Understanding the prevalence, reasons for use, and perceived benefits of CAM can help improve patient care and guide clinical practices. This study aimed to assess the prevalence, reasons for use, and perceived benefits of cupping therapy, apitherapy, and traditional cautery treatments among patients with rheumatic diseases. Additionally, it aimed to explore adverse effects, location and pricing disparities in CAM practices, information sources, and the rate of reporting CAM use to treat rheumatologists and to identify factors associated with the use of these CAM approaches. Methodology This single-center, cross-sectional study was conducted in a Moroccan University Hospital and included patients receiving care for rheumatic diseases during hospitalization or outpatient visits from January 2024 to March 2024. The data were collected using a structured, validated, and pilot-tested questionnaire administered by attending rheumatologists. The questionnaire aimed to gather demographic information and to identify patients using CAM, collecting data related to their utilization. Results A total of 100 patients were enrolled (mean age: 52.3 ± 12.8 years, 75% female). Among them, 43% had chronic inflammatory rheumatism. Additionally, 46% reported using at least one of the three CAM methods studied, with 36% using cupping therapy (specifically the wet method), 9% using apitherapy, and 16% using traditional cautery. The main reason for using CAM was to alleviate their pain (55%). Perceptions of effectiveness were reported by 38% of patients using cupping therapy, 20% using apitherapy, and 5.9% using traditional cautery. The use of CAM was significantly lower in patients with a university education (odds ratio = 0.05, 95% confidence interval = 0.003-0.92). Conclusions Our study revealed a significant prevalence of CAM use among patients with rheumatic diseases in Morocco, with cupping therapy emerging as the most commonly utilized method. These findings underscore the importance of enhancing awareness and understanding of CAM practices among both patients and healthcare providers to promote more structured and informed CAM practices.
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OBJECTIVE: To present a concept analysis of neglect, specifically examining its occurrence and implications in the context of family caregiving for older adults living with dementia. METHODS: A literature search was conducted in Medline, CINAHL, Scopus, and Embase databases in February 2023. Inclusion criteria targeted articles focusing on neglect in dementia family caregiving, leading to the identification of 11 articles for thorough review. Employing Caron and Bowers' dimensional analysis approach, the concept analysis aimed to elucidate neglect as a social construct shaped by diverse contexts, perspectives, and underlying assumptions. RESULTS: Neglect in this context emerged as a multidimensional phenomenon, influenced by contextual elements such as activities of daily living and behavioral symptoms of dementia. It encompasses dimensions including "expectations of unmet needs", "maladaptive behaviors", and "feelings of guilt", considering the perspectives of both caregivers and individuals living with dementia. Recognizing neglect as a dyadic phenomenon emphasizes the significance of interactions between caregivers and individuals living with dementia. CONCLUSION: A comprehensive understanding of neglect in dementia family caregiving is crucial for effective interventions and support systems. The dyadic perspective is vital for accurate assessment. Primary care physicians, mental health, nurses, and other health professionals play a key role in prevention and supporting family caregivers. Further research is needed to explore the dynamics of dementia caregiving settings strengthening prevention strategies against elder neglect.