scholarly journals An Increasing Prominent Disease ofKlebsiella pneumoniaeLiver Abscess: Etiology, Diagnosis, and Treatment

2013 ◽  
Vol 2013 ◽  
pp. 1-12 ◽  
Author(s):  
Yun Liu ◽  
Ji-yao Wang ◽  
Wei Jiang
Keyword(s):  
Survival Rates ◽  
Pyogenic Liver Abscess ◽  
The United States ◽  
Diagnostic Methods ◽  
Diagnosis And Treatment ◽  
Diabetic Patients ◽  
Imaging Features ◽  
Radiographic Findings ◽  
The Past ◽  
Liver Abscesses

Background. During the past two decades,Klebsiella pneumoniae(K. pneumoniae) had surpassedEscherichia coli(E. coli) as the predominant isolate from patients with pyogenic liver abscess (PLA) in Asian countries, the United States, and Europe, and it tended to spread globally. Since the clinical symptom is atypical, the accurate and effective diagnosis and treatment ofK. pneumoniaeliver abscesses (KLAs) are very necessary.Methods. Here, we have comprehensively clarified the epidemiology and pathogenesis of KLA, put emphases on the clinical presentations especially the characteristic radiographic findings of KLA, and thoroughly elucidated the most effective antibiotic strategy of KLA.Results. K1 serotype is strongly associated with KLA especially in diabetic patients. Computed tomography (CT) and ultrasound (US) were two main diagnostic methods of KLA in the past. Most of KLAs have solitary, septal lobular abscesses in the right lobe of liver, and they are mainly monomicrobial. Broad-spectrum antibiotics combined with the US-guided percutaneous drainage of liver abscesses can increase their survival rates, but surgical intervention still has its irreplaceable position.Conclusion. The imaging features contribute to the early diagnosis, and the percutaneous intervention combined with an aminoglycoside plus either an extended-spectrum betalactam or a second- or third-generation cephalosporin is a timely and effective treatment of KLA.

scholarly journals Toward Resolving the Challenges of Sepsis Diagnosis

2004 ◽  
Vol 50 (8) ◽  
pp. 1301-1314 ◽  
Author(s):  
Shawn D Carrigan ◽  
George Scott ◽  
Maryam Tabrizian
Keyword(s):  
Medical Diagnosis ◽  
Delayed Diagnosis ◽  
High Sensitivity ◽  
The United States ◽  
Immune Monitoring ◽  
Diagnostic Methods ◽  
Magic Bullet ◽  
Sepsis Diagnosis ◽  
The Past ◽  
Related Mortality

Abstract Sepsis in the United States has an estimated annual healthcare cost of $16.7 billion and leads to 120 000 deaths. Insufficient development in both medical diagnosis and treatment of sepsis has led to continued growth in reported cases of sepsis over the past two decades with little improvement in mortality statistics. Efforts over the last decade to improve diagnosis have unsuccessfully sought to identify a “magic bullet” proteic biomarker that provides high sensitivity and specificity for infectious inflammation. More recently, genetic methods have made tracking regulation of the genes responsible for these biomarkers possible, giving current research new direction in the search to understand how host immune response combats infection. Despite the breadth of research, inadequate treatment as a result of delayed diagnosis continues to affect approximately one fourth of septic patients. In this report we review past and present diagnostic methods for sepsis and their respective limitations, and discuss the requirements for more timely diagnosis as the next step in curtailing sepsis-related mortality. We also present a proposal toward revision of the current diagnostic paradigm to include real-time immune monitoring.

Pyogenic Liver Abscess in Normal Children With Fever of Unknown Origin

PEDIATRICS ◽  
1976 ◽  
Vol 58 (4) ◽  
pp. 614-616 ◽  
Author(s):  
Sheldon L. Kaplan ◽  
Ralph D. Feigin
Keyword(s):  
Abdominal Pain ◽  
Liver Abscess ◽  
Fever Of Unknown Origin ◽  
Unknown Origin ◽  
Pyogenic Liver Abscess ◽  
Liver Function Tests ◽  
Blood Cultures ◽  
Normal Children ◽  
The Past ◽  
Liver Abscesses

Solitary pyogenic hepatic abscesses were identified as the cause of fever, abdominal pain, and hepatomegaly in two otherwise normal children who were seen at St. Louis Children's Hospital during the past year. Liver function tests were normal and blood cultures were negative in both patients. These cases illustrate that pyogenic liver abscess may occur in normal children and should be considered whenever fever of unknown origin is associated with abdominal complaints. Only in this way can we hope to improve upon the results cited previously, namely that the majority of liver abscesses remain undiagnosed during life.

scholarly journals Research on the Development Status and Trends of Glaucoma Study Based on SCIE for Ten years

2019 ◽  
Author(s):  
Yunxiao Sun ◽  
Fanqi Kong ◽  
Yue Zhang ◽  
Siloka Arthur Labisi ◽  
Kai Cao
Keyword(s):  
Glaucoma Surgery ◽  
The United States ◽  
Diagnosis And Treatment ◽  
Development Status ◽  
The Past ◽  
Visual Science ◽  
Status And Trends ◽  
Before And After ◽  
Time Region ◽  
Research Hotspots

Abstract Background To explore the development status and trends of glaucoma study from 2009 to 2018 based on SCIE.Methods Searching for glaucoma-related articles published in SCIE in the last decade and describing the distribution of the time, region, author, author institution, journal and influence of articles. Meanwhile, we compared the publication of articles, the research hotspots among five years before and after 2009-2013, 2014-2018.Results A total of 19,609 glaucoma-related articles were retrieved during 2009-2018 and the global SCIE articles have increased year by year from 2009 to 2017. The top five countries for articles were the United States, China, Japan, Germany and the England. The top three authors are Weinreb, R N, Aung, T and Jonas, J B. The journal with the largest number of published articles is INVESTIGATIVE OPHTHALMOLOGY VISUAL SCIENCE. It can be seen that glaucoma-related pathogenesis research, OCT and other imaging examinations in the diagnosis and treatment of glaucoma and glaucoma surgery have attracted much attention.Conclusions In the past ten years, global glaucoma research has developed in a balanced manner, and the cooperation between various institutions and teams has become increasingly close. The research hotspots are still concentrated in the pathogenesis and diagnosis and treatment of glaucoma.

scholarly journals Volumes, outcomes, and complications after surgical versus endovascular treatment of aneurysms in the United States (1993–2015): continued evolution versus steady-state after more than 2 decades of practice

2020 ◽  
pp. 1-14 ◽  
Author(s):  
Pedram Golnari ◽  
Pouya Nazari ◽  
Roxanna M. Garcia ◽  
Hannah Weiss ◽  
Ali Shaibani ◽  
...  
Keyword(s):  
Endovascular Treatment ◽  
Fold Increase ◽  
The United States ◽  
Diagnosis And Treatment ◽  
Unruptured Aneurysms ◽  
Ruptured Aneurysms ◽  
The Past ◽  
The Us ◽  
Risk Ratios ◽  
Over Time

OBJECTIVEAdoption of endovascular treatment (EVT) and other advances in aneurysm care have shifted practice patterns of cerebral aneurysm treatment over the past 2 decades in the US. The objective of this study was to determine whether resulting trends in volumes, outcomes, and complications have matured in general practice or continue to evolve.METHODSData were obtained from the National Inpatient Sample from 1993 to 2015. ICD-9 codes were used to estimate annual volumes, outcomes, and complications following treatment of ruptured and unruptured aneurysms. Univariate and multivariate analyses were used to estimate risk ratios for complications and outcomes. Trends in time were assessed utilizing annual percentage change (APC).RESULTSThe authors found a nearly 5-fold increase in annual admissions with diagnoses of unruptured aneurysms, whereas SAH volume increased less than 50%. Clipping ruptured aneurysms steadily declined (APC −0.86%, p = 0.69 until 1999, then −6.22%, p < 0.001 thereafter), whereas clipping unruptured aneurysms slightly increased (APC 2.02%, p < 0.001). EVT tripled in 2002–2004 and steadily increased thereafter (APC 7.22%, p < 0.001 and 5.85%, p = 0.01 for unruptured and ruptured aneurysms, respectively). Despite a 3-fold increase in both diagnosis and treatment of unruptured aneurysms, the incidence of SAH remained steady at 12 per 100,000 persons per year (APC 0.04%, p = 0.83). In contrast, SAH severity increased over time, as did patient age and comorbidities (all p < 0.001). SAH led to nonroutine discharge more frequently over time after both EVT and clipping (APC 1.24% and 1.10%, respectively), although mortality decreased during the same time (APC −2.48% and −1.44%, respectively). Complications were more frequent after clipping than EVT, but this differential risk diminished during the study period and was less perceptible in ruptured aneurysms. The proportion of patients discharged home after treatment of unruptured aneurysms was significantly lower (p < 0.001) after clipping (69.3%–79.5%) than EVT (88.3%–93.3%); both proportions changed minimally since 1998 (APC −0.39%, p = 0.02, and APC −0.11%, p = 0.14, respectively).CONCLUSIONSEVT volume markedly increased for ruptured and unruptured aneurysms from 1993 to 2015, whereas clipping decreased for ruptured and slightly increased for unruptured aneurysms. The incidence of SAH remained unchanged despite increased diagnosis and treatment of unruptured aneurysms. In ruptured aneurysms, SAH severity has increased over time, as have age, comorbidities, and nonroutine discharges. In contrast, routine discharge after treatment of unruptured aneurysms remains largely unchanged since 1998 and remains lower with clipping.

scholarly journals Bibliometric Analysis of the Top 100 Most Cited Articles on Wrist Arthroscopy

2021 ◽  
Author(s):  
Nevzat Gönder ◽  
Volkan Kılınçoğlu
Keyword(s):  
Hand Surgery ◽  
The United States ◽  
Diagnosis And Treatment ◽  
Wrist Arthroscopy ◽  
Level Of Evidence ◽  
The Past ◽  
Triangular Fibrocartilage ◽  
Number Of Publications ◽  
Randomised Controlled ◽  
Number Of Citations

Abstract Background: Over the past few decades, more articles have been published about wrist arthroscopy. The purpose of this study was to identify and analyze the 100 most cited articles about wrist arthroscopy.Methods: The 100 most cited articles were analyzed using the wrist arthroscopy as a keyword on the Web of Science database. Original articles, reviews, clinical trials, and cadaveric studies were included in the study. We recorded and analyzed the following information: Article title, first author, year of publication, journal of publication, the total number of citations, level of evidence, article language, country, institution, and the main topic of study. Results: The number of citations ranged from 35 to 180 (mean, 64.74). The total number of citations was 6,474. Among the articles examined, the most prolific country was the United States of America (USA). The Journal of Hand Surgery- American Volume was the journal with the most number of publications and the most cited articles. The main topics that were most analyzed and underlined were the diagnostic comparison of Magnetic resonanas imaging and arthroscopy and the diagnosis and treatment of triangular fibrocartilage complex.Conclusions: As a result, wrist arthroscopy continues to develop, and it is a subject that is open for new studies. More comprehensive and up-to-date randomised controlled studies comparing the benefit of wrist arthroscopy or open surgery for wrist pathologies will demonstrate the importance of arthroscopy in the diagnosis and treatment of problems related to this topic.

scholarly journals Experience of long-term clinical observation of a patient with a rare type of stomach cancer – lymphoepithelioma-like carcinoma

2020 ◽  
pp. 277-282
Author(s):  
L. M. Kogoniya ◽  
L. E. Gurevich ◽  
V. S. Mazurin ◽  
E. V. Markarova
Keyword(s):  
Stomach Cancer ◽  
Survival Rates ◽  
Palliative Therapy ◽  
Diagnostic Methods ◽  
Rare Type ◽  
The Past ◽  
Methods Of Treatment ◽  
Improved Methods

Stomach cancer is one of the most frequently diagnosed cancers. The success of special methods of treatment are still disappointing in this disease, and stomach cancer has historically been considered a tumor refractory to treatment. Therefore, this category of patients, especially in the stage of dissemination, in most cases, palliative therapy is recommended. In recent years, the use of systemic chemotherapy and targeted therapy has led to a significant improvement in the quality of life and survival rates for stomach cancer compared to palliative therapy. However, significant progress in diagnostic methods over the past two decades has made it possible and possible to review approaches to the treatment of many cancer diseases that are refractory to chemotherapy. The last 2 decades, due to improved methods of diagnosis have allowed to revise approaches to the treatment of many refractory to chemotherapy of neoplastic diseases. In particular, the literature describes cases of revision and changes due to pre-existing diagnosis of IHC Research (carcinoid, NEO, stomach cancer, pancreatic cancer). This communication allows to share their own long experience of observation and treatment of a patient with a rare form of stomach cancer – lymphoepithelioma-like carcinoma.

scholarly journals Pyogenic Liver Abscess with No Predisposing Risk Factors

2018 ◽  
Vol 2018 ◽  
pp. 1-4
Author(s):  
Matthew Chadwick ◽  
Leonid Shamban ◽  
Michael Neumann
Keyword(s):  
Risk Factors ◽  
Magnetic Resonance Cholangiopancreatography ◽  
Pyogenic Liver Abscess ◽  
The United States ◽  
Pancreatic Disease ◽  
Factors Associated ◽  
Source Of Infection ◽  
Liver Abscesses ◽  
History Of ◽  
Right Upper Quadrant Ultrasound

Pyogenic liver abscesses (PLA) are an uncommon cause of hospitalization in the United States. The majority of such cases are polymicrobial and are most commonly caused by seeding of infection from the biliary system. PLA is frequently associated with specific comorbidities such as diabetes mellitus, history of liver transplant, underlying hepatobiliary, or pancreatic disease. Herein, we describe a 47-year-old healthy male with no known risk factors associated with PLA who presented to the hospital with acute fever, abdominal pain, and dark colored urine. Initially the patient had a negative right upper quadrant ultrasound. However, the patient continued to have persistent fevers and abnormal liver biochemistries with negative liver serology that led to checking a magnetic resonance cholangiopancreatography which suggested multiple liver abscesses. Computer tomography guided aspiration revealed a monobacterial Streptococcus species within the abscess, which is commonly associated with arterial bacteremia as a source of PLA. Arterial bacteremia is one of most rare causes of PLA. The patient’s septic workup was negative for any source of infection. This case demonstrates a patient with no risk factors who was diagnosed with PLA caused by apparent arterial bacteremia with no clear source of infection.

International Research and Variation in Views of Ethnicity

2012 ◽  
Vol 2 (2) ◽  
pp. 66-72
Author(s):  
Ella Inglebret ◽  
Amy Skinder-Meredith ◽  
Shana Bailey ◽  
Carla Jones ◽  
Ashley France
Keyword(s):  
United States ◽  
Classification System ◽  
International Research ◽  
The United States ◽  
Research Articles ◽  
Journal Articles ◽  
Research Participants ◽  
The Past ◽  
International Scale ◽  
Publication Patterns

The authors in this article first identify the extent to which research articles published in three American Speech-Language-Hearing Association (ASHA) journals included participants, age birth to 18 years, from international backgrounds (i.e., residence outside of the United States), and go on to describe associated publication patterns over the past 12 years. These patterns then provide a context for examining variation in the conceptualization of ethnicity on an international scale. Further, the authors examine terminology and categories used by 11 countries where research participants resided. Each country uses a unique classification system. Thus, it can be expected that descriptions of the ethnic characteristics of international participants involved in research published in ASHA journal articles will widely vary.

Proportion of Individuals With Past-Year Suicidal Ideation Who Attempted Suicide Over the Past 10 Years in the United States, and the Influence of Age and Sex

Crisis ◽  
2020 ◽  
pp. 1-5
Author(s):  
Shannon Lange ◽  
Courtney Bagge ◽  
Charlotte Probst ◽  
Jürgen Rehm
Keyword(s):  
United States ◽  
Suicidal Ideation ◽  
Random Effects ◽  
Attempted Suicide ◽  
Suicide Attempts ◽  
The United States ◽  
Individual Level ◽  
The Past ◽  
Meta Analyses ◽  
Age Category

Abstract. Background: In recent years, the rate of death by suicide has been increasing disproportionately among females and young adults in the United States. Presumably this trend has been mirrored by the proportion of individuals with suicidal ideation who attempted suicide. Aim: We aimed to investigate whether the proportion of individuals in the United States with suicidal ideation who attempted suicide differed by age and/or sex, and whether this proportion has increased over time. Method: Individual-level data from the National Survey on Drug Use and Health (NSDUH), 2008–2017, were used to estimate the year-, age category-, and sex-specific proportion of individuals with past-year suicidal ideation who attempted suicide. We then determined whether this proportion differed by age category, sex, and across years using random-effects meta-regression. Overall, age category- and sex-specific proportions across survey years were estimated using random-effects meta-analyses. Results: Although the proportion was found to be significantly higher among females and those aged 18–25 years, it had not significantly increased over the past 10 years. Limitations: Data were self-reported and restricted to past-year suicidal ideation and suicide attempts. Conclusion: The increase in the death by suicide rate in the United States over the past 10 years was not mirrored by the proportion of individuals with past-year suicidal ideation who attempted suicide during this period.

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