ABSTRACT
Objective: The impact of establishing a pulmonary embolism response team (PERT) in patients with pulmonary embolism (PE) has been proven in many developed countries. However, the efficacy of a PERT largely depends on expertise and infrastructure. This study explored the benefit of establishing a PERT in developing countries with limited healthcare resources by comparing the outcomes of patients with acute PE before and after PERT establishment at University Medical Center Ho Chi Minh City in Vietnam. Methods: We conducted a single-center observational study from January 1, 2019, to August 1, 2021. All patients with PE confirmed on computed tomography were included. Patients admitted before PERT establishment were treated by cardiologists alone, while those hospitalized after PERT establishment were managed by the PERT. Results: A total of 130 patients were included (pre-PERT estab-lishment: 51 patients; post-PERT establishment: 79 patients). The demographic characteristics, severity of PE, and clinical and laboratory findings were similar between the two groups. The post-PERT establishment group had a lower incidence rate of major and clinically relevant nonmajor bleeding (11.3% vs. 31.4%, p = 0.005) and required more interventional therapies (16.5% vs. 3.9%, p = 0.046) than did the pre-PERT establishment group. The in-hospital mortality rate decreased in the post-PERT establishment group compared with that in the pre-PERT establishment group (8.9% vs. 21.6%, p = 0.041). Conclusions: Involvement of the PERT in PE management was associated with improved outcomes of patients with PE, including reduced bleeding and mortality rates in a resource-constrained hospital.
Subject(s)
Developing Countries , Pulmonary Embolism , Humans , Hospital Mortality , Hospitalization , Hospitals , Pulmonary Embolism/therapyABSTRACT
OBJECTIVE: A new pandemic coronavirus causing coronavirus disease-2019 (COVID-19), initially called 2019-nCoV and successively named Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). The COVID-19 refers to the disease while the SARS-CoV-2 refers to the virus and is characterized by a rapid contagious capacity able to spread worldwide in a very short time. The rise in the number of infected patients and deaths is of great concern especially because symptoms are vague and similar to other forms of flu infection and corona syndrome infections characterized by fever, fatigue, dry cough, and dyspnea. According to the latest guidelines published by the World Health Organization (WHO), the diagnosis of COVID-19 must be confirmed by quantitative reverse transcription polymerase chain reaction (rRT-PCR) or gene sequencing of specimen obtained from throat, sputum and blood samples. However, the limitations due to logistics, as well as low sensitivity and specificity diagnostic tools currently available have been reported as the main cause of high incidence of either false-negative or positive results. PATIENTS AND METHODS: The purpose of the present translational research protocol is to discuss and present the original findings from our research team on new diagnostic technique to detect four Coronaviridae family members (SARS-CoV-2, SARS-CoV, HCoV and MERS-CoV), highlighting the methodology, the procedure and the possible advantages. Moreover, the authors review the current epidemiology, precautions and safety measures for health personnel to manage patients with known or suspected COVID-19 infection. RESULTS: Implementation of an effective and rapid plan of diagnosing, screening and checking is a key factor to reduce and prevent further transmission. This procedure based on rRT-PCR could be of great help to decisively validate the results obtained from more conventional diagnostic procedures such as chest computed tomography (CT) imaging and chest ultrasound. CONCLUSIONS: This translational diagnostic tool will assist emergency and primary care clinicians, as well as out-of-hospital providers, in effectively managing people with suspected or confirmed SARS-CoV-2.
Subject(s)
Coronavirus Infections/diagnosis , International Cooperation , Pneumonia, Viral/diagnosis , Translational Research, Biomedical , Betacoronavirus/isolation & purification , COVID-19 , COVID-19 Testing , Clinical Laboratory Techniques , Humans , Italy , Middle East Respiratory Syndrome Coronavirus/isolation & purification , Pandemics , Reverse Transcriptase Polymerase Chain Reaction , Severe acute respiratory syndrome-related coronavirus/isolation & purification , SARS-CoV-2 , Sensitivity and Specificity , VietnamABSTRACT
Several methods are presently available for gene expression analysis. However, few of them are suitable for detection of moderate numbers of genes in thousands of samples with high speed and low cost. There is great demand for such a method for use in diagnostics and screening. To address this need, we have developed an assay for gene expression analysis using microspheres and a fluidic instrument made by Luminex. The assay is named Beads Array for the Detection of Gene Expression (BADGE). BADGE can monitor up to 100 genes in a single reaction, and it takes only 1 h to hybridize and <20 sec to read the results of all 100 genes in a sample for the detection process. For the genes detected in five independent replicate experiments, the standard deviation was <35% of the mean. We have monitored multiple pathogenesis-related genes simultaneously in chemical-treated and control Arabidopsis samples employing the BADGE assay. The data were compared with those obtained from an established technology, Affymetrix GeneChip. The changes in expression profiles were very similar. Our study showed that the BADGE assay was capable of profiling expression of multiple genes at affordable cost and rapid speed.
Subject(s)
Gene Expression Profiling/methods , Molecular Diagnostic Techniques/methods , Oligonucleotide Array Sequence Analysis/methods , Arabidopsis/drug effects , Arabidopsis/genetics , DNA Probes/genetics , Gene Expression Regulation, Plant/drug effects , Gene Expression Regulation, Plant/genetics , Humans , Microspheres , Plant Proteins/genetics , Plant Proteins/metabolism , RNA, Complementary/genetics , Sensitivity and Specificity , Thiadiazoles/pharmacology , Time FactorsABSTRACT
The quality of ovarian stimulation for in vitro fertilization with or without an LH-RH analogue was investigated in a randomized trial involving 30 women divided into 3 groups. Group I women were treated with the conventional clomiphene citrate-human menopausal gonadotropin combination without LH-RH analogue. Group II women (long regimen) received a slow-release preparation of triptorelin (DTRp6-LH-RH), an LH-RH analogue, and human menopausal gonadotropin. Group II women (short regimen) were given triptorelin with human menopausal gonadotropin. Inhibition of the endogenous luteinizing hormone using triptorelin improved the results of in vitro fertilization in group II and group III women, but the short regimen was distinctly less compelling and less expensive than the long regimen.
Subject(s)
Fertilization in Vitro , Gonadotropin-Releasing Hormone/analogs & derivatives , Luteinizing Hormone/antagonists & inhibitors , Luteolytic Agents/pharmacology , Ovulation/drug effects , Adult , Delayed-Action Preparations , Female , Gonadotropin-Releasing Hormone/pharmacology , Humans , Random Allocation , Stimulation, Chemical , Triptorelin PamoateABSTRACT
The authors analyze the diagnosis and the results of the treatment of 43 patients presenting simple polyps of the isthmo-interstitial segment of the tube with at least a 2 years follow-up. The study was carried out between 1980 and 1983. It was a prospective, non-randomized study. They conclude that the medical treatment, which gives excellent results, is advantageous. Microsurgical treatment (reimplantation or isthmo-ostial anastomosis) is only used after failure of the medical treatment.
Subject(s)
Fallopian Tube Neoplasms/surgery , Polyps/surgery , Fallopian Tube Neoplasms/diagnostic imaging , Female , Humans , Polyps/diagnostic imaging , RadiographyABSTRACT
The authors report the results of LH-RH blocking by an analogue for the purpose of obtaining a more constant inducement of ovulation. It concerns a delayed action product, the inconvenience of which is a possible extended action beyond thirty days, which could have an unfavorable effect on the luteal phase.
Subject(s)
Gonadotropin-Releasing Hormone/analogs & derivatives , Gonadotropin-Releasing Hormone/antagonists & inhibitors , Infertility, Female , Ovulation Induction/methods , Adult , Female , Fertilization in Vitro , Gonadotropin-Releasing Hormone/therapeutic use , Humans , Triptorelin PamoateABSTRACT
The authors, who operated on 187 patients with 277 interstitial sections of the isthmus, describe their microsurgical techniques for isthmo-ostial anastomosis, for isthmo-ostial reimplantation and for isthmo-uterine reimplantation. Histological analysis of the lesions and the anatomical features of the proximal segment of the tube justify their method. Patency is re-established and the results are encouraging. All the same, these partial proximal lesions can be markedly improved with success by medical treatment before operation.
Subject(s)
Fallopian Tube Diseases/surgery , Microsurgery/methods , Female , HumansSubject(s)
Gonadotropin-Releasing Hormone/analogs & derivatives , Ovulation Induction/methods , Pituitary Gland, Anterior/drug effects , Female , Fertilization in Vitro , Gonadotropin-Releasing Hormone/administration & dosage , Gonadotropin-Releasing Hormone/pharmacology , Humans , Injections, Intramuscular , Triptorelin PamoateABSTRACT
With regard to the retrospective and prospective analysis of two series of patients, a first series concerning 180 patients presenting pathology of the isthmo-interstitial segment of the oviduct, and a second series concerning 149 patients operated on for extrauterine pregnancy, the authors have established the responsibility of the pathology of the proximal segment in a very large number of cases of sterility regarded as inexplicable, and in a certain number of cases of extrauterine pregnancy. Medical treatment with danazol gives remarkable results. In cases of failure of medical treatment, microsurgery involves isthmo-ostial reimplantation.
Subject(s)
Fallopian Tube Diseases/complications , Pregnancy, Tubal/etiology , Danazol/therapeutic use , Fallopian Tube Diseases/pathology , Fallopian Tube Diseases/therapy , Fallopian Tubes/pathology , Female , Humans , Microsurgery , Pregnancy , Prospective Studies , Retrospective StudiesABSTRACT
The author describes the technical details of microsurgery in tubal sterility, stressing the advantage of the use of the microscope in the pathology of the proximal segment of the uterine tube.
Subject(s)
Fallopian Tube Diseases/surgery , Infertility, Female/surgery , Microsurgery , Fallopian Tube Diseases/complications , Female , Humans , Infertility, Female/etiology , Suture Techniques , Tissue Adhesions/surgeryABSTRACT
PIP: 83 patients users of Copper 200 were observed for a total of 760 months, together with 20 users of Gravigard, for 280 months. Age of users was between 19-43. Failure rate was 1.57% for the Copper 200, and 4.28% for Gravigard; continuity rate was 93.7% with Copper 200, and 91.44% with Gravigard. A few patients complained of pain and/or menorrahgia. Such results indicate that both IUDs were well tolerated; still, the utmost importance of a careful selection of patients and type of device must be stressed. (Summary in ENG).^ieng
Subject(s)
Contraception , Intrauterine Devices, Copper , Intrauterine Devices , Research , Contraception Behavior , Evaluation Studies as Topic , Family Planning ServicesABSTRACT
The authors demonstrate the innocuousness of the method of removal of the Pouch of Douglas after a critical analysis of 50 cases followed up for between 6 months and 5 years. They believe that simple removal of the pelvic peritoneum is sufficient to overcome the condition of a pathological fold of peritoneum, but not sufficient on the other hand to correct the condition of retroverted uterus because two new peritoneal fossae form lateral to the viscerae easily because of the morphology of the pelvic cavity. They therefore stress that, at the time of the operation, it is important to suture the utero-sacral ligaments together in the sagittal plane.
