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Role of octreotide in small bowel bleeding

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World Journal of Clinical Cases 2022年第26期10卷 9192-9206页

作者： anwar khedr Esraa Elaraby Mahmoud Noura Attallah Mikael Mir Sydney Boike Ibtisam Rauf Abbas B Jama Hisham Mushtaq Salim Surani Syed A Khan Department of Internal Medicine BronxCare Health SystemBronxNY 10457United States Department of Medicine University of SharjahSharjah 27272United Arab Emirates Critical Care Medicine Mayo Clinic Health SystemMankatoMN 56001United States Department of Medicine University of MinnesotaMinneapolisMN 55455United States Department of Medicine St.George School of MedicineGrenadaWest Indies Department of Medicine Texas A&M University Health Science CenterBryanTX 77807United States

Gastrointestinal bleeding accounts for a drastic negative impact on the quality of the patients’lives as it requires multiple diagnostic and therapeutic interventions to identify the source of the *** bowel bleeding is the least common cause of gastrointestinal ***,it is responsible for the majority of complaints from patients with persisting or recurring bleeding where the primary source of bleeding cannot be identified despite investigation.A somatostatin analog known as octreotide is among the medical treatment modalities currently used to manage small bowel *** medication helps control symptoms of gastrointestinal bleeding by augmenting platelet aggregation,decreasing splanchnic blood flow,and antagonizing *** this review article,we will highlight the clinical efficacy of octreotide in small bowel bleeding and its subsequent effect on morbidity and mortality.

关键词： Octreotide Small bowel Hemorrhage Angiodysplasia Vascular malformations Hereditary hemorrhagic telangiectasia

Sodium-glucose cotransporter-2 inhibitor-associated euglycemic diabetic ketoacidosis in COVID-19-infected patients: A systematic review of case reports

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世界临床病例杂志 2023年第24期11卷 5700-5709页

作者： anwar khedr Hussam Al Hennawi Muhammed Khuzzaim Khan Aalaa Eissa Mikael Mir Ibtisam Rauf Jain Nitesh Salim Surani Syed Anjum Khan Department of Medicine Bronx Care Health SystemBronxNY 10457United States Department of Internal Medicine Jefferson Abington HospitalAbingtonPA 19001United States Department of Internal Medicine Dow University of Health ScienceKarachi 74200Pakistan Department of Medicine Kafrelsheikh UniversityKFS 33511Egypt Department of Medicine University of MinnesotaMinneapolisMN 55455United States Department of Medicine St.George’s UniversitySchool of MedicineSt.George SW170REGrenada Department of Critical Care Mayo Clinic Health SystemMankatoMN 56001United States Department of Medicine&Pharmacology Texas A&M UniversityCollege StationTX 77843United States Department of Critical Care Medicine Mayo Clinic Health SystemMankatoMN 56001United States

BACKGROUND Diabetic ketoacidosis(DKA)manifests as hyperglycemia,metabolic acidosis,and ***,euglycemic DKA(eu-DKA)conceals severe DKA with glucose levels below 200 mg/***-glucose cotransporter-2(SGLT2)inhibitors can induce eu-DKA in diabetic ***,coronavirus disease 2019(COVID-19)-infected individuals with diabetes using SGLT2 inhibitors face an augmented risk of eu-DKA due to the direct toxic impact of the virus on pancreatic *** study aims to comprehensively investigate the association between SGLT2 inhibitors and eu-DKA in COVID-19 patients through meticulous case report ***,we endeavor to examine the outcomes and treatment approaches for COVID-19-infected diabetics receiving SGLT2 inhibitors,providing indispensable insights for healthcare professionals managing this specific patient *** To investigate the connection between SGLT2 inhibitors and euglycemic DKA in COVID-19 patients through a meticulous analysis of case *** We conducted an exhaustive search across prominent electronic databases,including PubMed,SCOPUS,Web of Science,and Google *** search encompassed the period from December 2019 to May 2022,incorporating published studies and *** search terms employed encompassed“SGLT2 inhibitors”,“euglycemic DKA”,“COVID-19”,and related *** incorporating these diverse sources,our objective was to ensure a thorough exploration of the existing literature on this subject,thereby augmenting the validity and robustness of our *** Our search yielded a total of seven case reports and one case series,collectively comprising a cohort of twelve *** reports detailed instances of eu-DKA in individuals with ***,all twelve patients were utilizing SGLT2 as their primary anti-diabetic *** admission,all oral medications were promptly discontinued,and the patients were initiated on intravenous insulin therapy to effectively ma

关键词： Sodium-glucose transporter 2 inhibitors COVID-19 SARS-CoV-2 Diabetic ketoacidosis Euglycemic diabetic ketoacidosis Diabetes mellitus

Overlap of diabetic ketoacidosis and hyperosmolar hyperglycemic state

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World Journal of Clinical Cases 2022年第32期10卷 11702-11711页

作者： Esraa Mamdouh Hassan Hisham Mushtaq Esraa Elaraby Mahmoud Sherley Chhibber Shoaib Saleem Ahmed Issa Jain Nitesh Abbas B Jama anwar khedr Sydney Boike Mikael Mir Noura Attallah Salim Surani Syed A Khan Critical Care Medicine Mayo Clinic Health SystemMankatoMN 56001United States Medicine St.Vincent's Medical CenterBridgeportCT 06606United States Medicine College of MedicineUniversity of SharjahSharjah 27272United Arab Emirates Medicine Mercy Catholic Medical CenterDarbyPA 19025United States Medicine Mayo HospitalLahore 54000PunjabPakistan Medicine Medical University of the AmericasNevisWest Indies Medicine BronxCare Health SystemBronxNY 10457United States Medicine University of Minnesota Medical SchoolMinneapolisMN 55455United States Medicine&Pharmacology Texas A&M University Health Science CenterCollege StationTX 77843United States Anesthesiolgy Mayo ClinicRochesterMN 55905United States

Diabetic ketoacidosis(DKA)and hyperosmolar hyperglycemia state(HHS)are two life-threatening metabolic complications of diabetes that significantly increase mortality and *** major advances,reaching a uniform consensus regarding the diagnostic criteria and treatment of both conditions has been challenging.A significant overlap between these two extremes of the hyperglycemic crisis spectrum poses an additional *** has well been noted that a complete biochemical and clinical patient evaluation with timely diagnosis and treatment is vital for symptom ***,there is a lack of large-scale studies that help define how hyperglycemic crises should be *** article will provide a comprehensive review of the pathophysiology,diagnosis,and management of DKA-HHS overlap.

关键词： Diabetic ketoacidosis Hyperosmolar Coma Diabetes Metabolic acidosis Hypernatremia Hyperosmolar hyperglycemia state

Effect of fibrinolytic therapy on ST-elevation myocardial infarction clinical outcomes during the COVID-19 pandemic:A systematic review and meta-analysis

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World Journal of Cardiology 2023年第6期15卷 309-323页

作者： anwar khedr Hussam Al Hennawi Muhammed Khuzzaim Khan Mostafa Elbanna Abbas B Jama Ekaterina Proskuriakova Hisham Mushtaq Mikael Mir Sydney Boike Ibtisam Rauf Aalaa Eissa Meritxell Urtecho Thoyaja Koritala Nitesh Jain Lokesh Goyal Salim Surani Syed A Khan Department of Internal Medicine BronxCare Health SystemBronxNY 10457United States Department of Internal Medicine Jefferson Abington HospitalAbingtonPA 19001United States Department of Internal Medicine Dow University of Health ScienceKarachi 74200Pakistan Department of Internal Medicine Rochester Regional HealthRochesterNY 14621United States Department of Critical Care Mayo Clinic Health SystemMankatoMN 56001United States Department of Internal Medicine Mount Sinai HospitalChicagoIL 60608United States Department of Internal Medicine St.Vincent's Medical CenterBridgeportCT 06606United States Department of Medicine University of MinnesotaMinneapolisMN 55455United States Department of Medicine St.George's UniversitySchool of MedicineSt George SW170REGrenada Department of Medicine KFS UniversityKFS 33511Egypt Department of Medicine Robert D and Patricia E.Kern Center of Health Care DeliveryMayo ClinicRochesterMN 55905United States Department of Hospital Medicine Mayo Clinic Health SystemMankatoMN 56001United States Department of Medicine Mayo Clinic Health SystemMankatoMN 56001United States Department of Hospital Medicine Christus Sphon Hospital-shorelineCorpus ChristoTX 78404United States Department of Pulmonary Critical Care&Sleep MedicineTexas A&M UniversityCollege StationTX 77843United States Department of Critical Care Medicine Mayo Clinic Health SystemMankatoMN 56001United States

BACKGROUND ST-elevation myocardial infarction(STEMI)is the result of transmural ischemia of the myocardium and is associated with a high mortality *** percutaneous coronary intervention(PPCI)is the recommended first-line treatment strategy for patients with *** timely delivery of PPCI became extremely challenging for STEMI patients during the coronavirus disease 2019(COVID-19)pandemic,leading to a projected steep rise in *** delays were overcome by the shift from first-line therapy and the development of modern fibrinolytic-based *** is unclear whether fibrinolytic-based reperfusion therapy is effective in improving STEMI *** To determine the incidence of fibrinolytic therapy during the COVID-19 pandemic and its effects on STEMI clinical *** PubMed,Google Scholar,Scopus,Web of Science,and Cochrane Central Register of Controlled Trials were queried from January 2020 up to February 2022 to identify studies investigating the effect of fibrinolytic therapy on the prognostic outcome of STEMI patients during the *** outcomes were the incidence of fibrinolysis and the risk of all-cause *** were meta-analyzed using the random effects model to derive odds ratios(OR)and 95%confidence *** assessment was carried out using the Newcastle-Ottawa *** Fourteen studies including 50136 STEMI patients(n=15142 in the pandemic arm;n=34994 in the pre-pandemic arm)were *** mean age was 61 years;79%were male,27%had type 2 diabetes,and 47%were *** with the pre-pandemic period,there was a significantly increased overall incidence of fibrinolysis during the pandemic period[OR:1.80(1.18 to 2.75);I2=78%;P=0.00;GRADE:Very low].The incidence of fibrinolysis was not associated with the risk of all-cause mortality in any *** countries with a low-and middle-income status reported a higher incidence of fibrinolysis[OR:5.16(2.18 to 12.22);I2=81%;P=0.00;GRADE:Very lo

关键词： ST-elevation myocardial infarction Myocardial infarction Thrombolytic therapy Fibrinolysis COVID-19 Pandemics

Intensive care unit adaptations in the COVID-19 pandemic:Lessons learned

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World Journal of Virology 2022年第6期11卷 394-398页

作者： anwar khedr David Rokser Jeanine Borge Hannah Rushing Greta Zoesch Wade Johnson Han-Yin Wang April Lanz Brian N Bartlett Jessica Poehler Salim Surani Syed A Khan Department of Medicine BronxCare Health SystemBronxNY 10457United States Department of Critical Care Medicine Mayo Health SystemMankatoMN 56001United States Department of Critical Care Medicine Mayo Clinic Health SystemMankatoMN 56001United States Department of Administration Mayo Clinic Health SystemMankatoMN 56001United States Hospital Medicine Mayo Clinic Health SystemMankatoMN 56001United States Department of Emergency Medicine Mayo Clinic Health SystemMankatoMN 56001United States Department of Medicine Texas A&M UniversityHealth Science CenterCollege StationTX 77843United States

The coronavirus disease 2019 pandemic had deleterious effects on the healthcare systems around the *** increase intensive care units(ICUs)bed capacities,multiple adaptations had to be made to increase surge *** this editorial,we demonstrate the changes made by an ICU of a midwest community hospital in the United *** changes included moving patients that used to be managed in the ICU to progressive care units,such as patients requiring noninvasive ventilation and high flow nasal cannula,ST-elevation myocardial infarction patients,and post-neurosurgery ***,newer tactics were applied to the processes of assessing oxygen supply and demand,patient care rounds,and post-ICU monitoring.

关键词： COVID-19 Pandemics Oxygen Intensive care units ST elevation myocardial infarction Nasal cannula