JUNIOR MEDICAL RESEARCH最新文献

{"title":"The place of digital devices and artificial intelligence in cardiac arrhythmia management: new advances, practical guides, and promising prospects.","authors":"Chernikova Daryna, Mohamed Mohamed Mohsen Ahmed","doi":"10.32512/mr.5.1.2022/7.9","DOIUrl":"https://doi.org/10.32512/mr.5.1.2022/7.9","url":null,"abstract":"Developing digital devices and remote technologies for the diagnosis and management of arrhythmias are revolutionizing cardiologist clinical practice and decision-making. Electrocardiogram (ECG) and plethysmography (PPG)-based devices are widely used to assess cardiac rhythm. Artificial intelligence (AI) enabled devices may contribute to early detection and monitoring of atrial fibrillation (AF), long QT syndrome (LQTS), as well as QTc related adverse drug events. Some other devices such as contactless rhythm monitoring may be useful in ambulatory cardiac arrhythmia mass screening.\u0000\u0000Keywords\u0000Digital device ;Arrhythmia ;Atrial fibrillation ;Artificial intelligence ;Review.","PeriodicalId":354267,"journal":{"name":"JUNIOR MEDICAL RESEARCH","volume":"12 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132992753","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The dark side of the sun: Affected demographics of skin cancers","authors":"Ocarina Lin, Khachemoune Amor, Chawkat Leila","doi":"10.32512/jmr.4.2.2021/11.13","DOIUrl":"https://doi.org/10.32512/jmr.4.2.2021/11.13","url":null,"abstract":"Basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) are the most common skin malignancies. BCC and SCC are affecting the corresponding cells in the epidermis where tumorogenesis starts. The onset of these diseases is caused by sun exposure and ultraviolet radiation (UVR). However, it seems that there are more vulnerable groups within the population. Several other leading factors have been described in the literature. Elderly, male and fair-skinned individuals may have significantly increased skin cancer risk. Understanding the characteristics of these cancers epidemiology may allow their early detection and ensure better medical and surgical management. Keywords: Skin cancer risk; Ultraviolet radiation; Sun exposure; Sun protection; Review.","PeriodicalId":354267,"journal":{"name":"JUNIOR MEDICAL RESEARCH","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129991658","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Abnormal Origin of the Left Coronary artery from the Pulmonary artery and autism spectrum disorder.","authors":"","doi":"10.32512/jmr.4.2.2021/19.20","DOIUrl":"https://doi.org/10.32512/jmr.4.2.2021/19.20","url":null,"abstract":"","PeriodicalId":354267,"journal":{"name":"JUNIOR MEDICAL RESEARCH","volume":"32 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115395446","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dyspnea in the elderly: Diagnostic contribution of the differentiation index","authors":"","doi":"10.32512/jmr.4.2.2021/7.10","DOIUrl":"https://doi.org/10.32512/jmr.4.2.2021/7.10","url":null,"abstract":"Background Dyspnea is a common disabling symptom of cardiopulmonary diseases and a considerable reason of emergency room (ER) consultation and hospital admission. In elderly patients, it is sometimes difficult to distinguish between the cardiac and the respiratory origin due to critical presentation. The aim of this study was to assess diagnostic accuracy of the dyspnea differentiation index (DDI). Methods This study is a prospective single centre analysis including patients aged over 65 years consulting ER for dyspnea. Sixty-five patients were included over a period of six months. The etiology of the dyspnea was established according to the findings of the echocardiogram. Dyspnea differentiation index (DDI= PRFxSpo2/1000) was calculated for all the patients. Sensibility and specificity were assessed using the ROC curve. Results Mean included patients age was 75±8 years. Sex ratio was 0.85. Dyspnea had cardiac origin in 38.5% and non-cardiac origin in 61.5% of cases. Mean DDI was higher in the cardiac origin group (15.3vs 9.3, p=0.002). the predictive positive value was 71% and the predictive negative value was 86%. The optimal ROC curve cut-off showed DDI sensibility of 80% and specificity of 77.5%. Conclusions DDI is simple tool easy to calculate with satisfactory diagnostic accuracy that may guide the management of critical dyspnea in elderly before the routine investigation. Key words Dyspnea; Elderly; Emergency room; Echocardiography, Index.","PeriodicalId":354267,"journal":{"name":"JUNIOR MEDICAL RESEARCH","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129971624","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hepatic Mesenchymal Hamartoma in Children","authors":"","doi":"10.32512/jmr.4.2.2021/14.16","DOIUrl":"https://doi.org/10.32512/jmr.4.2.2021/14.16","url":null,"abstract":"Hepatic mesenchymal hamartoma is a rare benign tumor arising from the mesenchyma of the portal tract. Hamartoma usually presents before the third year of life. Remarkable abdominal swelling is the most frequent clinical feature. We herein present a new case with a comprehensive literature review. The aim was to highlight he clinical , radiological and histopathological characteristics of this entity. Keywords: Mesenchyma; Hamartoma; Liver tumor; Children.","PeriodicalId":354267,"journal":{"name":"JUNIOR MEDICAL RESEARCH","volume":"19 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115889693","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tele-critical health care: Lessons learned from the pandemic","authors":"D. Chernikova","doi":"10.32512/jmr.4.2.2021/2","DOIUrl":"https://doi.org/10.32512/jmr.4.2.2021/2","url":null,"abstract":"The approach of remotely managing critically ill patients via an off-site command center was implemented since decades. However, SARS COV-2 pandemic lockdown triggered an urgent need for more innovations to ensure the continuity of intensive care units services when self-isolation was needed to prevent and reduce infection rates. Hence, implementing tele-intensive care units (tele-ICU) became a must and seems to be the future system cornerstone. The Society of Critical Care Medicine's Tele-ICU committee has recently described various models of tele-critical care (TCC) and its current adapted applications [1]. The ability to regionalize advanced critical care support such as nonconventional mechanical ventilation modes, extracorporeal membrane oxygenation, and other complex needs may be simplified with telemedicine [2]. Experienced intensivists can provide a real-time support to the local teams and participate to the decision making while performing virtual rounds using high-definition audio/visual (A/V) equipment. Moreover, TCC may enhance the intervention quality for emergency situations such as advanced cardiac life support. The immediate delivery of an intensivist to the room via A/V technology may save time and promptly initiate life-saving procedures. Instead of “all hands-on deck” approach, code leadership by a tele-ICU intensivist may allow to reduce the number of the on-site responding staff. The benefit was objective in several scenarios during the pandemic era and enabled a full compliance with the social distancing requirements [3]. The COVID Caregiver Cockpit is an approved connected health care solution which is compliant with the FDA classification for Mobile Medical Devices. It offers various enhanced features that allow remote patient monitoring, and secure inpatient ward staff communications. COVID Caregiver Cockpit might be an example of the great flexibility and adaptability of TCC solutions with unexpected emergencies [4]. The cost of Tele-ICU varies depending on the setting, hardware, software, training, and compatibility issues with other health systems. Cost was usually considered as limiting factor for the implementation of eHealth solutions. However, the return on investment (ROI) for an implemented Tele-ICU seems to be satisfactory especially in case of shortage in bedside board-certified intensivists [5]. Physician acceptance of TCC technologies was not optimal at the beginning of the experience. However, the urgent need during the pandemic has permitted to prove the TCC efficacy and increased its acceptability. Based on this objective benefit of TCC, several savant and scientific societies recommended the integration of telemedicine consultations into routine clinical care [6]. Recent reviews of the literature provided several examples of successfully implemented telehealth services. A framework of patient-centered telehealth models implementation should be introduced in all clinical practice settings [7,8].","PeriodicalId":354267,"journal":{"name":"JUNIOR MEDICAL RESEARCH","volume":"30 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129078051","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gastrostomy and fundoplication in neurologically impaired children: A benefit-risks confrontation","authors":"","doi":"10.32512/jmr.4.2.2021/3.6","DOIUrl":"https://doi.org/10.32512/jmr.4.2.2021/3.6","url":null,"abstract":"Background For children with neurological impairment (NI) and swallowing incoordination feeding gastrostomy is usually required. This procedure may cause or aggravate preexisting gastroesophageal reflux disease (GERD). Fundoplication has been advocated at the time of gastrostomy placement in these patients. The purpose of this study is to evaluate clinical impact and risk-benefit balance of fundoplication and gastrostomy tube placement in patients with NI due to cerebral palsy, Hypoxic ischemic encephalopathy, brain tumors, and Dandy-Walker syndrome. Methods This study is a ten-year retrospective analysis including 180 cases of gastric tube placement in neurologically impaired children performed in a single institution. Results One hundred eighty patients underwent gastrostomy tube (GT)placement (94 open versus 86 laparoscopic). Concomitant fundoplication was performed in 44 cases. Three different types of tube were used during the procedures. There were differences between the two groups in gender but not in age distribution or comorbidity. Fundoplication was laparoscopic in 29 cases (33.7%) and open in 15 (16.0%). Postoperative diarrhea was more frequently observed with the Mickey tube (p=0.008). the hospital stay was longer after Mic tube placement (p=001). Sequelae after gastrostomy tube placement were observed in 21 cases (p=0.015). five postoperative cases of death were noted (p=0.015). The recurrence rate of reflux was 71% and mortality rate was 63% on long term follow-up. Conclusions In this study on NI and swallowing disorder unresponsive to medical treatment, open or laparoscopic fundoplication and gastrostomy reduced nausea and pain after feeding, but not Apparent life-threatening event in infancy (ALTE). Potential increased risk of complications and the procedure results instability may indicate the implementation of new management guidelines. Key words Fundoplication; Gastrostomy; Neurological impairment; Children, Outcome.","PeriodicalId":354267,"journal":{"name":"JUNIOR MEDICAL RESEARCH","volume":"7 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116996070","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of augmented reality telesurgery: Lessons learned from Covid-19 pandemic","authors":"","doi":"10.32512/jmr.3.3.2020/28","DOIUrl":"https://doi.org/10.32512/jmr.3.3.2020/28","url":null,"abstract":"Virtual reality (VR) is an artificially simulated environment that permits multiple\u0000interactions. Augmented reality (AR) is an interactive experience of a real-world\u0000environment where the objects are enhanced by computer-generated perceptual\u0000information [1,2].\u0000Enhanced versions of these concepts were being used in several clinical practices.\u0000Virtual Interactive Presence (VIP) is a technology by which surgeons located\u0000remotely can simultaneously view each other's visual field, allowing them to telecollaborate long distance surgeries [3]. Virtual interactive presence and augmented\u0000reality (VIPAR) platform allows a surgeon from a remote location to deliver realtime assistance to a local surgeon using a standard internet connection.\u0000Pandemic typically led to a surge in demand for healthcare services overwhelming\u0000usually local capabilities. The SARS-Cov-2 outbreak was a big challenge for both\u0000patients and health practitioners. Surgical procedures were reserved only to most\u0000critical cases. Long lockdown limited patients’ access to different health facilities.\u0000Most of the savant societies recommended implementing telemedicine and\u0000incorporating telemedicine as part of COVID-19 outbreak response systems [4].\u0000Telemedicine involves not only consultation, radiodiagnosis and clinical follow up\u0000but also surgical procedures and surgeon’s assisting guidance.\u0000Telemedicine is no longer a futuristic tool. It becomes a need in the present\u0000situation where human interaction has been made difficult by the pandemic. The\u0000touch sense haptic technology and teledactyl were predicted since 1878. Nowadays\u0000it may provide a more realistic and “physical” doctor- patient interaction remotely.\u0000Since the first successful tele-laparoscopic cholecystectomy in 2001, telesurgery\u0000allowed collaboration between different surgeons located distantly across world.\u0000This Tele-collaboration contributed to complex wound repairs in war zones. The\u0000same concept was useful in the management of some high-risk procedures such\u0000as emergency surgeries in COVID-19 positive patients [5,6].\u0000Telesurgery could revolutionize training concept as well. Real-time access to three‐\u0000dimensional reconstructions in patient imaging and remote interaction with\u0000colleagues may provide comprehensive high-quality skills transfer [7].\u0000Before 2020, telesurgery was always an exciting technology but with unclear\u0000endpoints. The limited access to tele-guided procedures was mostly explained by\u0000the lack of patient’s trust and the high cost. The pandemic outbreak taught us a\u0000lot about its safety and effectiveness. Nowadays, health care delivery is feasible\u0000anytime in all restricted areas.","PeriodicalId":354267,"journal":{"name":"JUNIOR MEDICAL RESEARCH","volume":"45 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124920368","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inverted flap in the management of idiopathic large macular holes: A comparative study of different techniques","authors":"Zgolli Hsouna, Mabrouk Sonya, Maslah Tarek, Fekih Olfa, Malek Ines, Nacef Leila","doi":"10.32512/jmr.3.3.2020/3.8","DOIUrl":"https://doi.org/10.32512/jmr.3.3.2020/3.8","url":null,"abstract":"Background\u0000Macular holes are vitreoretinal interface disorders due to anatomical defects in the\u0000fovea causing poor central vision. The aim of this study was to compare the results of\u0000four different variants of inverted flap (IF) technique, for the closure of macular holes\u0000larger than 400µm.\u0000Methods\u0000This is a prospective comparative case series. Thirty-six eyes with large macular hole\u0000were enrolled: group 1: inserted internal limiting membrane (ILM); group 2: classic IF\u0000ILM; group 3: IF without manipulation (Free Flap technique), group 4: temporal IF\u0000technique. Best-corrected visual acuity (BCVA), anatomical closure rate, and ellipsoid\u0000zone (EZ) and external limiting membrane (ELM) defects were evaluated\u0000preoperatively, at 1 month and 3 months after surgery. Odds ratio (OR) and its 95%\u0000confidence interval (CI) were used to compare the anatomical and functional results\u0000of classic inverted flap ILM peeling (group 2) and modified inverted flap ILM peeling\u0000(Group 1,3 and 4).\u0000Results\u0000Mean BCVA improved in all four groups 3 months after surgery. The improvement\u0000was significant in group 2,3, and 4 (P=0.001). The rate of successful hole closure\u0000ranged from 87.5% to 100% in different groups (P=0.661). The integrity of EZ was\u0000achieved in 65.6% and the restoration of the inner layers of the retina in 71.5%.\u0000Conclusion\u0000Inverted flap ILM technique is efficient for the treatment of large full thickness\u0000macular hole (FTMH). Different modified inverted flap techniques have been\u0000described on the last decade. Through our study, we demonstrated that the inserted\u0000flap, may alter outer retinal layer and compromise final functional results despite final\u0000closure of the macular hole. The classic IF technique, the temporal and the free flap\u0000techniques have finally comparable good functional and anatomical results.\u0000Key words\u0000inverted flap technique, macular hole, surgery, outcomes","PeriodicalId":354267,"journal":{"name":"JUNIOR MEDICAL RESEARCH","volume":"31 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122176294","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical criteria for Peutz-Jeghers syndrome diagnosis: Look for what is missing","authors":"","doi":"10.32512/jmr.3.3.2020/22.23","DOIUrl":"https://doi.org/10.32512/jmr.3.3.2020/22.23","url":null,"abstract":"The Peutz-Jeghers syndrome (PJS) is an autosomal dominant disorder characterized by\u0000hamartomatous gastrointestinal polyposis and mucocutaneous melanin pigmentation. In\u0000this report we discuss diagnostic circumstances of new PJS family.\u0000Keywords:\u0000Intestinal obstruction; intussusception; Peutz-Jeghers syndrome; polyps; surgery.","PeriodicalId":354267,"journal":{"name":"JUNIOR MEDICAL RESEARCH","volume":"92 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124623845","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}