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Cardiovascular complications following medical termination of pregnancy: An updated review

World Journal of Cardiology 2023年第10期15卷 518-530页

作者： Tejveer Singh Ajay K Mishra Nikhil Vojjala Kevin John John Anu A George Anil Jha michelle hadley Department of Internal Medicine Saint Vincent HospitalWorcesterMA 01608United States Division of Cardiology Saint Vincent HospitalWorcesterMA 01608United States Department of Internal Medicine Post-Graduation Institute of Medical Education and ResearchChandigarh 00000India Department of Internal Medicine Tufts Medical CenterBostonMA 01212United States

BACKGROUND Around 1 million cases of medical termination of pregnancy(MTP)take place yearly in the United States of America with around 2 percent of this population developing *** cardiovascular(CVD)complications occurring post MTP or after stillbirth is not very well *** To help the reader better understand,prepare,and manage these complications by reviewing various cardiac comorbidities seen after *** We performed a literature search in PubMed,Medline,RCA,and google scholar,using the search terms“abortions”or“medical/legal termination of pregnancy”and“cardiac complications”or“cardiovascular complications”.RESULTS The most common complications described in the literature following MTP were infective endocarditis(IE)(n=16),takotsubo cardiomyopathy(TTC)(n=7),arrhythmias(n=5),and sudden coronary artery dissection(SCAD)(n=4).The most common valve involved in IE was the tricuspid valve in 69%(n=10).The most observed causative organism was group B Streptococcus in 81%(n=12).The most common type of TTC was apical type in 57%(n=4).Out of five patients de veloping arrhythmia,bradycardia was the most common and was seen in 60%(3/5)of the *** four cases of SCAD-P type presented as acute coronary syndrome 10-14 d post termination of pregnancy with predominant involvement of the right coronary *** was only reported following IE in 6.25%.Clinical recovery was reported consistently after optimal medical management following all these *** In conclusion,the occurrence of CVD complications following pregnancy termination is infrequently documented in the existing *** this review,the most common CVD complication following MTP was noted to be IE and TTC.

关键词： Cardiovascular complications Termination of pregnancy Infective Endocarditis Stress cardiomyopathy Outcome

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Takotsubo cardiomyopathy following envenomation:An updated review

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World Journal of Cardiology 2023年第1期15卷 33-44页

作者： Ajay K Mishra Anu A George Kevin John John Pramukh Arun Kumar Mahati Dasari Mohammed Afraz Pasha michelle hadley Division of Cardiology Saint Vincent HospitalWorcesterMA 01608United States Department of Medicine Saint Vincent HospitalWorcesterMA 01608United States Department of Medicine Tufts Medical CenterBostonMA 02111United States Department of Medicine North Alabama Medical CenterFlorenceAL 35630United States

BACKGROUND Takotsubo cardiomyopathy(TTC)can be diagnosed in patients presenting with clinical features of acute coronary syndrome(ACS)by using Mayo clinic *** precipitators have been attributed to causing *** it has been reported to occur following an acute *** This review describes the various patterns,mechanisms,and outcomes of envenomation induced *** In this review,we included all studies on“TTC”and“envenomation”published in the various databases before June *** be included in the review articles had to have a distinct diagnosis of TTC and an envenomation RESULTS A total of 20 patients with envenomation induced TTC were *** episodes of envenomation induced TTC were reported following a bee sting,scorpion sting,and snake *** and anxiety related to the sting,direct catecholamine toxicity and administration of exogenous beta-adrenergic agents have been commonly postulated to precipitate TTC in these patients.95%of these patients presented with a clinical picture of *** of these patients also fulfill at least 3 out of 4 criteria of Mayo clinic criteria for *** evidence of Apical TTC was noted in 72%of patients.94%of these patients had clinical improvement following optimal management and 35%of these patients were treated with guideline directed medications for heart *** Envenomation following multiple insect stings and reptile bites can precipitate *** reported envenomation related TTC has been due to bee stings and scorpion *** mechanisms causing TTC were fear,anxiety,and stress of *** of these patients present with clinical presentation of ACS,ST elevation,and elevated *** most common type of TTC in these patients is Apical,which improved following medical management.

关键词： Takotsubo cardiomyopathy Envenomation Mechanism Outcome

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Evidence supporting the relationship between maternal asthma and risk for autism spectrum disorders

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Neural Regeneration Research 2025年第4期20卷 1101-1102页

作者： hadley Osman Paul Ashwood Department of Medical Microbiology and Immunology and the M.I.N.D.InstituteUniversity of California at DavisSacramentoCAUSA

During pregnancy,maternal immune activation(MIA),due to infection,chronic inflammatory disorders,or toxic exposures,can result in lasting health impacts on the developing *** has been associated with an increased risk of neurodevelopmental disorders,such as autism spectrum disorder(ASD)in the *** is characterized by increased repetitive and stereotyped behaviors and decreased *** of 2020,1 in 36 children are diagnosed with ASD by the age of 8 years,with ASD rates continuing to increase in prevalence in USA(Tamayo et al.,2023).Post-mortem brain studies,biomarker and transcriptomic studies,and epidemiology studies have provided compelling evidence of immune dysregulation in the circulation and brain of individuals diagnosed with ***,the etiology of ASD is largely unknown,however,genetic components and environmental factors can contribute to increased *** allergic asthma(MAA),a form of MIA,has been identified as a potential risk factor for developing neurodevelopmental disorders(Patel et al.,2020).Asthma is a chronic inflammatory condition driven by a T-helper type(TH)2 immune response.

关键词： disorders epidemiology fetus

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Application of anti-CD103 immunotoxin for saving islet allograft in context of transplantation

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Chinese Medical Journal 2010年第24期123卷 3644-3651页

作者： ZHANG Lei Gregg A. hadley Department of General Surgery the Second Affiliated Hospital of Harbin Medical University Harbin Heilongjiang 150086 China Division of Transplantation Department of Surgery the Ohio State University Medical Center Columbus OH 43210 USA

Background Previous studies using knockout mice document a key role for the integrin CD103 in promoting organ allograft rejection and graft-versus-host disease. However, a determination of whether blockade of the CD103 pathway represents a viable therapeutic strategy for intervention in these processes has proven problematic due to the lack of reagents that efficiently deplete CD103＋ cells from wild type hosts. To circumvent this problem, in the present study, we invented an anti-CD103 immunotoxin （M290-SAP）. We investigated whether M290-SAP has capacity to eliminate CD103-expressing cells in vivo and protect transplanted islets from destroying by host immune *** Flow cytometry was used to analyze the efficacy of M290-SAP in depleting CD103-expressing cells in *** using allogenic islet transplantation models as well as NOD mice with recent onset type 1 diabetes, the therapeutic efficacy of CD103-expressing cell depletion was *** M290-SAP dramatically reduces the frequency and absolute numbers of CD103-expressing leukocytes in peripheral lymphatic tissues of treated mice. Balb/c islets transplanted into streptozotocin-induced diabetic C57BL/6 mice under single M290-SAP treatment showed an indefinite survival time compared with untreated mice, M290-treated mice and IgG-SAP treated mice （mean survival time, ＞100 days vs. ＜20 days）. C57BL/6 islets transplanted into hyperglycemic NOD mice under single M290-SAP treatment showed a pronounced delay in allograft rejection compared with untreated mice （mean survival time 12-13 days vs. ＜7 days）. Immunological analysis of mice with long-term islet allograft survival revealed an obvious atrophy thymus and severe downregulation of alloimmunity of CD8 subpopulation response to allogenic *** Regardless of the underlying mechanisms, these data document that depletion of CD103-expressing cells represents a viable strategy for therapeutic intervention in islet allograft rejection.

关键词： immunotoxin saporin CD8 T lymphocytes pancreatic islets transplantation thymus

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Reality of evidence-based practice in palliative care

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Cancer Biology & Medicine 2015年第3期12卷 193-200页

作者： Claire Visser Gina hadley Bee Wee Harris Manchester College University of Oxford Sir Michael Sobell House Oxford University Hospitals NHS Trust

There has been a paradigm shift in medicine away from tradition, anecdote and theoretical reasoning from the basic sciences towards evidence-based medicine(EBM). In palliative care however, statistically significant benefits may be marginal and may not be related to clinical meaningfulness. The typical treatment vs. placebo comparison necessitated by ‘gold standard' randomised controlled trials(RCTs) is not necessarily applicable. The complex multimorbidity of end of life care involves considerations of the patient's physical, psychological, social and spiritual needs. In addition, the field of palliative care covers a heterogeneous group of chronic and incurable diseases no longer limited to cancer. Adequate sample sizes can be difficult to achieve, reducing the power of studies and high attrition rates can result in inadequate follow up periods. This review uses examples of the management of cancer-related fatigue and death rattle(noisy breathing) to demonstrate the current state of EBM in palliative care. The future of EBM in palliative care needs to be as diverse as the patients who ultimately derive benefit. Non-RCT methodologies of equivalent quality, validity and size conducted by collaborative research networks using a ‘mixed methods approach' are likely to pose the correct clinical questions and derive evidencebased yet clinically relevant outcomes.

关键词： Palliative care evidence-based medicine (EBM) multimorbidity clinical meaningfulness

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Management of prostatosymphyseal fistula following photoselective vaporization of the prostate:Case series and systematic review of the literature

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Current Urology 2022年第2期16卷 88-93页

作者： Scott D.Lundy Nicholas Hauser hadley Wood Amr Fergany Kenneth Angermeier Glickman Urological and Kidney Institute Cleveland ClinicClevelandOHUSA Department of Urology University of MiamiMiamiFLUSA Sebastian River Medical Center SebastianFLUSA

Background:This study is aimed to describe our institutional experience and review the literature to date on prostatosymphyseal fistula(PSF),or puboprostatic fistula,following bladder outlet procedures such as transurethral resection of the prostate(TURP)or laser photoselective vaporization of the prostate(PVP).Materials and methods:We retrospectively queried our institutional experience for management of PSF following PVP performed for symptomatic benign prostatic *** also performed a systematic literature review for PSF following PVP or ***,we describe our surgical approach to the management of this challenging ***:We identified 7 cases of PSF following PVP from our institution,as well as an additional 7 cases following PVP and 9 cases following TURP from literature *** diagnosis of PSF was made between 0.5 and 24 months following PVP,and the most specific symptoms were pubic pain and difficulty *** patients requiring several evaluations before the diagnosis was made using appropriate imaging *** percent of patients required surgical intervention including fistula repair or *** surgical approach has evolved,and we now routinely perform robotic fistula repair with Y-V plasty and interposition flap with excellent ***:Puboprostatic fistula is a rare and poorly described complication of PVP or *** the best of our knowledge,this case series of PSF following PVP represents the largest series to date and doubles the number of reported cases in the *** fistula repair with interposition of either peritoneal or perivesical fat flaps appears to be a viable management strategy.

关键词： Fistula Laser Prostatosymphyseal fistula Puboprostatic fistula Reconstructive surgery

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CD103免疫毒素在同种胰岛移植中的应用

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中华实验外科杂志 2011年第2期28卷 194-196页

作者：张雷 Gregg hadley 哈尔滨医科大学附属第二医院普通外科 150086 美国俄亥俄州立大学移植外科

目的制备能体内杀伤CD103表达细胞的免疫毒素,观察其对同种胰岛移植排斥反应的影响.方法将CD103抗体与植物毒素saporin耦联产生M290-SAP,以2 mg/kg剂量注入小鼠腹腔,实验分为磷酸盐缓冲液（PBS）、IgG-SAP、M290和M290-SAP组,用流式... 详细信息

目的制备能体内杀伤CD103表达细胞的免疫毒素,观察其对同种胰岛移植排斥反应的影响.方法将CD103抗体与植物毒素saporin耦联产生M290-SAP,以2 mg/kg剂量注入小鼠腹腔,实验分为磷酸盐缓冲液（PBS）、IgG-SAP、M290和M290-SAP组,用流式细胞术检测CD103阳性细胞的肖减,之后将M290-SAP应用于化学性糖尿病小鼠胰岛移植模型,观察胰岛有功能存活情况.结果 PBS、IgG-SAP和M290组,肠上皮内CD103＋CD8＋淋巴细胞占CD3＋淋巴细胞的百分比分别为70.9%、68.4%和79.5%,而M290-SAP组几乎降至0;M290-SAP也杀灭了CD103＋的胸腺细胞.M290-SAP组胰岛移植物存活时间（＞100 d,n=9）,明显优于未处理组、IgG-SAP和M290组（均在20d内排斥）（P＜0.01）.结论 M290-SAP消除CD103表达细胞能促进同种胰岛移植物长期存活.

关键词：胰岛移植胸腺免疫毒素抗-CD103 CD8T淋巴细胞

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CD103分子介导CD8^＋T淋巴细胞对同种胰岛移植物的损伤

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中华器官移植杂志 2011年第2期32卷 91-94页

作者：张雷 Gregg hadley 哈尔滨医科大学附属第二医院普外一科 150086 The Ohio State University

目的检验CD103分子是否介导了CD8^＋T淋巴细胞对同种移植胰岛的免疫损伤。方法用流式细胞仪检测野生型C57BL／6小鼠外周血CD8^＋T淋巴细胞表达CDl03的情况。以Balb／c小鼠为供者，C57BL／6小鼠为受者，制作同种胰岛移植模型。受者分为3... 详细信息

目的检验CD103分子是否介导了CD8^＋T淋巴细胞对同种移植胰岛的免疫损伤。方法用流式细胞仪检测野生型C57BL／6小鼠外周血CD8^＋T淋巴细胞表达CDl03的情况。以Balb／c小鼠为供者，C57BL／6小鼠为受者，制作同种胰岛移植模型。受者分为3组：M290-SAP组小鼠注射CDl03免疫毒素M290-SAP；M290组小鼠注射抗CDl03单克隆抗体M290；另以仅接受胰岛移植、不注射任何药物的小鼠为未处理组。检测移植胰岛CD3、CD8、CD44和CDl03阳性细胞的表达，检测肠系膜淋巴结中CD3、CD8和CD103阳性细胞的表达。移植物功能丧失或观察期结束时获取移植胰岛，行HE染色和免疫组织化学染色。结果野生型C57BL／6小鼠外周血的CD8^＋T淋巴细胞中有44．06％表达CDl03。未处理组移植胰岛浸润的细胞成分中有29％的CD8^＋T淋巴细胞表达CDl03。M290-SAP组小鼠淋巴细胞不仅丧失了CDl03的表达，而且CD8^＋T淋巴细胞的绝对数量也减少，该组小鼠血糖稳定时间超过100d（未处理组为13d，P〈C0．05），移植胰岛组织学形态良好。结论CD8^＋T淋巴细胞免疫损伤同种移植胰岛必须表达CDl03，CDl03有可能成为胰岛移植抗排斥反应治疗的新靶点。

关键词：胰岛移植 CD103 CD8 免疫毒素类

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展望2004

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中国皮革 2004年第15期33卷 48-49页

作者： Phil hadley 王立新

肉食与家畜委员会(MLC)在2004年1月28日主持召开了一个以'展望2004的转变与机遇'为议题的会议,会议的目的是探讨英国未来几年畜牧业及其相关行业的最新发展趋势,来自畜牧业、肉食业以及相关领域的150多位代表参加了会议.

关键词：英国畜牧业发展趋势肉食业肉食与家畜委员会 2004年

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聚焦原料皮

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中国皮革 2004年第21期33卷 53-55页

作者： P J hadley 王立新

无论对于BLC的研究项目还是商务活动而言 ,有关原料皮的工作一直扮演着重要的角色 ,而且 ,这方面的工作也越来越受到政府的特别关注。现今 ,我们一直研究的是有关畜牧业对皮革质量、数量和肉食安全卫生的影响 ,并研究在屠宰场受到污染... 详细信息

无论对于BLC的研究项目还是商务活动而言 ,有关原料皮的工作一直扮演着重要的角色 ,而且 ,这方面的工作也越来越受到政府的特别关注。现今 ,我们一直研究的是有关畜牧业对皮革质量、数量和肉食安全卫生的影响 ,并研究在屠宰场受到污染的动物皮与公共健康之间的密切关系。2 0 0 0年 4月由UK的食品标准机构(FSA)发起 ,由环境、食品和农业事务(DEFRA)部门共同协作提出 ,食品安全卫生的改善是各行业共同努力的中心问题。对于皮革行业来讲 ,以安全为中心的条款进一步推动了清洁饲养的发展 ,更加强调了肉食安全研究并在行业内普及的重要性 ,这项工作的深入进行 ,预示着皮革质量的长期稳定和持续性改善。本论文的中心是肉食安全问题。

关键词：原料皮 FSA 肉食安全有害细菌皮革质量

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