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World Journal of Nephrology 2023年第3期12卷 66-72页

作者： maulik K Lathiya Praveen Errabelli Salvatore mignano susan m cullinan Department of Emergency medicine Mayo Clinic Health SystemEau ClaireWI 54703United States Department of Nephrology Mayo Clinic Health SystemEau ClaireWI 54703United States Department of Pathology Mayo ClinicRochesterMN 55905United States

BACKGROUND Anaplasmosis is a tick-borne disease with a range of clinical manifestations,from a flu-like illness with fever and myalgias to a severe systemic disease with multisystem organ *** renal involvement is not a common presentation,there have been few cases reporting acute kidney injury from *** SUmmARY We present a 55-year-old female with anaplasmosis who developed acute kidney injury due to membranoproliferative glomerulonephritis(mPGN).The patient originally presented with cough and shortness of *** was admitted to the hospital with a diagnosis of community acquired pneumonia and received *** the hospital course she developed severe acute renal *** serological work up didn’t provide any conclusive ***,she underwent kidney biopsy which showed mPGN pattern suggesting autoimmune,multiple myeloma or infectious *** work up was undertaken which was negative for autoimmune diseases,vasculitis panel,paraproteinemias but tested positive for IgG anaplasma with high titers indicating *** Our case shows a unique presentation of severe acute renal failure from mPGN from tick borne *** is usually seen with autoimmune diseases,hepatitis C virus infections,***,we suggest that tick borne illness should also be considered when evaluating acute renal failure cases in tick borne prevalent regions.

关键词： Acute kidney injury membranoproliferative glomerulonephritis Tick-borne Anaplasmosis Case report

Severe hypernatremia in hyperglycemic conditions;managing it effectively:A case report

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World Journal of Critical Care medicine 2023年第1期12卷 29-34页

作者： maulik K Lathiya Praveen Errabelli susan m cullinan Emeka J Amadi Department of Emergency Mayo Clinic Health SystemEau ClaireWI 54703United States Department of Nephrology Mayo Clinic Health SystemEau ClaireWI 54703United States Hospital Internal medicine Mayo Clinic Health SystemEau ClaireWI 54703United States

BACKGROUND Diabetic ketoacidosis(DKA)and hyperglycemic hyperosmolar state(HHS)are common acute complications of diabetes mellitus with a high risk of *** combined with hypernatremia,the complications can be even *** is a rarely associated with DKA and HHS as both are usually accompanied by normal sodium or *** a result,a structured and systematic treatment approach is *** discuss the therapeutic approach and implications of this uncommon *** SUmmARY A 62-year-old man with no known past medical history presented to emergency department with altered mental *** work up in emergency room showed severe hyperglycemia with a glucose level of 1093 mg/dL and severe hypernatremia with a serum sodium level of 169 mEq/*** was admitted to the intensive care unit(ICU)and was started on insulin drip as per DKA *** 12 h of ICU admission,blood sugar was 300 mg/*** his mental status didn’t show much *** was dehydrated and had a corrected serum sodium level of>190 mEq/*** a result,dextrose 5%in water and ringer's lactate were *** was also given free water via an nasogastric(NG)tube and IV Desmopressin to improve his free water deficit,which improved his serum sodium to 140 mEq/*** The combination of DKA,HHS and hypernatremia is rare and extremely challenging to manage,but the most challenging part of this condition is selecting the correct type of fluids to treat these *** case illustrates that desmopressin and free water administration via the NG route can be helpful in this situation.

关键词： Diabetic ketoacidosis Hyperglycemic hyperosmolar state Hypernatremia Hyperglycemia Desmopressin Case repot

Vasopressin-induced hyponatremia in an adult normotensive trauma patient:A case report

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World Journal of Critical Care medicine 2023年第1期12卷 35-40页

作者： maulik K Lathiya Emily Pepperl Daniel Schaefer Hussam Al-Sharif Adel Zurob susan m cullinan Antonios Charokopos Department of Emergency medicine Mayo Clinic Health SystemEau ClaireWI 54703United States Department of Pulmonary and Critical Care medicine Mayo Clinic Health SystemEau ClaireWI 54703United States

BACKGROUND Arginine vasopressin is a neuropeptide produced in the hypothalamus and released by the posterior pituitary *** addition to maintaining plasma osmolarity,under hypovolemic or hypotensive conditions,it helps maintain plasma volume through renal water reabsorption and increases systemic vascular *** synthetic analogues are widely used in the intensive care unit as a continuous infusion,in addition to hospital floors as an intravenous or intranasal dose.A limited number of cases of hyponatremia in patients with septic or hemorrhagic shock have been reported previously with *** report for the first time a normotensive patient who developed vasopressin-induced *** SUmmARY A 39-year-old man fell off a forklift and sustained an axial load injury to his *** had no history of previous *** was normal except for motor and sensory *** Imagine test showed endplate fracture at C7 and acute traumatic disc at C7 with cortical *** underwent cervical discectomy and fusion,laminectomy,and posterior instrumented *** intensive care unit admission post-surgery,he developed hyponatremia of 121-124 mEq/L post phenylephrine and vasopressin infusion to maintain blood pressure *** was evaluated for syndrome of inappropriate secretion of antidiuretic hormone,hypothyroid,adrenal-induced,or diuretic-induced *** the end of extensive evaluation for the underlying cause of hyponatremia,vasopressin was *** was also put on fluid restriction,given exogenous desmopressin,and a dextrose 5%in water infusion to prevent osmotic demyelination syndrome caused by sodium overcorrection which improved his sodium level to 135 mmol/*** The presentation of vasopressin-induced hyponatremia is uncommon in normotensive patients,and the most difficult aspect of this condition is determining the underlying cause of *** case illustrates that,considering the vast diffe

关键词： Hyponatremia Vasopressin Normotensive Therapy Case report

fRAP 2.0:a community engagement method applied to cervical cancer disparities among Hispanic women

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Family medicine and Community Health 2024年第S2期12卷 44-57页

作者： Autumn m Kieber-Emmons susan E Hansen michael Topmiller Jaskaran Grewal Carlos Roberto Jaen Benjamin F Crabtree William L miller Department of Family medicine Lehigh Valley Health NetworkAllentownPennsylvaniaUSA College of medicine USFTampaFloridaUSA Lehigh Valley Health Network AllentownPennsylvaniaUSA American Academy of Family Physicians-Health Landscape CincinattiOHUSA Lafayette College EastonPennsylvaniaUSA UT Health San Antonio San AntonioTexasUSA Rutgers Robert Wood Johnson medical School PiscatawayNew JerseyUSA Cancer Institute of New Jersey New BrunswickNew JerseyUSA

focused Rapid Assessment Process(fRAP)2.0 is a community engagement approach combining geospatial mapping with rapid qualitative assessment in cyclical fashion within communities to capture multifactorial and multilevel features impacting primary care *** 2.0 offers primary care researchers a methodology framework for exploring complex community features that impact primary healthcare delivery and *** fRAP 2.0 study design expands the fRAP from a sequential design to a cyclical process of geospatial mapping and rapid qualitative assessment in search of modifiable contextual *** participants are stakeholders from various socioecological levels whose perspectives inform study outcomes that they may use to then become the agents of change for the very problems they helped ***,we present a proof-of-concept study for fRAP 2.0 examining disparities in cervical cancer mortality rates among Hispanic women in *** primary outcomes of interest are features at the community level,medical health system level and regional government policy levels that offer opportunities for collaborative interventions to improve cervical cancer *** this study,geospatial mapping of county and ZIP code-level variables impacting postdiagnosis cervical cancer care at community,medical and policy levels were created using publicly available data and then overlaid with maps created with Texas Cancer Registry data for cervical cancer cases in three of the largest population *** disparate areas were then qualitatively explored using participant observation and ethnographic field work,alongside 39 key informant *** discussion groups and stakeholder engagement existed at every phase of the *** the fRAP 2.0 method,we created an action-oriented roadmap of next steps to improve cervical cancer care disparities in the three Texas counties with emphasis on the high disparity *** identified local change

关键词： cervical qualitative policy

Erlotinib combination with a mitochondria-targeted ubiquinone effectively suppresses pancreatic cancer cell survival

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World Journal of Gastroenterology 2024年第7期30卷 714-726页

作者： Pui-Yin Leung Wenjing Chen Anissa N Sari Poojitha Sitaram Pui-Kei Wu susan Tsai Jong-In Park Department of Biochemistry Medical College of WisconsinMilwaukeeWI 53226United States Department of Surgery Medical College of WisconsinMilwaukeeWI 53226United States

BACKGROUND Pancreatic cancer is a leading cause of cancer-related *** activity of the epidermal growth factor receptor(EGFR)is often observed in pancreatic cancer,and the small molecule EGFR inhibitor erlotinib has been approved for pancreatic cancer therapy by the food and drug ***,erlotinib alone is ineffective and should be combined with other drugs to improve therapeutic *** previously showed that certain receptor tyrosine kinase inhibitors can increase mitochondrial membrane potential(Δψm),facilitate tumor cell uptake ofΔψm-sensitive agents,disrupt mitochondrial homeostasis,and subsequently trigger tumor cell *** has not been tested for this *** To determine whether erlotinib can elevateΔψm and increase tumor cell uptake ofΔψm-sensitive agents,subsequently triggering tumor cell ***Δψm-sensitive fluorescent dye was used to determine how erlotinib affectsΔψm in pancreatic adenocarcinoma(PDAC)cell *** viability of conventional and patient-derived primary PDAC cell lines in 2D-and 3D cultures was measured after treating cells sequentially with erlotinib and mitochondria-targeted ubiquinone(mitoQ),aΔψm-sensitive *** synergy between erlotinib and mitoQ was then analyzed using SynergyFinder *** preclinical efficacy of the twodrug combination was determined using immune-compromised nude mice bearing PDAC cell line *** Erlotinib elevatedΔψm in PDAC cells,facilitating tumor cell uptake and mitochondrial enrichment ofΔψm-sensitive *** triggered caspase-dependent apoptosis in PDAC cells in culture if used at high doses,while erlotinib pretreatment potentiated low doses of *** suggested that these drugs synergistically induced tumor cell *** with in vitro data,erlotinib and mitoQ combination suppressed human PDAC cell line xenografts in mice more effectively than single treatments of each *** Our findings suggest tha

关键词： Pancreatic cancer Erlotinib mitochondria-targeted ubiquinone mitochondria Combination therapy

Early anticoagulation in patients with stroke and atrial fibrillation is associated with fewer ischaemic lesions at 1 month: the ATTUNE study

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Stroke & Vascular Neurology 2024年第1期9卷 30-37,I0034页

作者： Angelos Sharobeam Longting Lin Christina Lam Carlos Garcia-Esperon Yash Gawarikar Ronak Patel matthew Lee-Archer Andrew Wong michael Roizman Amanda Gilligan Andrew Lee Kee meng Tan susan Day Christopher Levi Stephen m Davis mark Parsons Bernard Yan melbourne Brain Centre at Royal melbourne Hospital ParkvilleVictoriaAustralia University of New South Wales South Western Sydney Clinical School LiverpoolNew South WalesAustralia Department of Neurology John Hunter HospitalNewcastleNew South WalesAustralia Department of Neurology Calvary Public HospitalCanberraAustralian Capital TerritoryAustralia Department of Neurology Northern Hospital EppingEppingVictoriaAustralia Department of Neurology Royal Brisbane and Women's HospitalHerstonQueenslandAustralia The University of Queensland School of medicine HerstonQueenslandAustralia Neurosciences Clinical Institute Epworth HealthcareRichmondVirginiaAustralia Department of Neurology Austin HealthUniversity of MelbourneHeidelbergVictoriaAustralia Flinders University College of medicine and Public Health AdelaideSouth AustraliaAustralia Department of Neurology Gold Coast University HospitalSouthportQueenslandAustralia The University of Sydney Northern Clinical School St LeonardsNew South WalesAustralia Department of Neurology and Neurophysiology Liverpool HospitalLiverpoolNew South WalesAustralia

Background The optimal time to commence anticoagulation in patients with atrial fibrillation(AF)after ischaemic stroke or transient ischaemic attack(TIA)is unclear,with guidelines differing in recommendations.A limitation of previous studies is the focus on clinically overt stroke,rather than radiologically obvious diffusion-weighted imaging ischaemic *** aimed to quantify silent ischaemic lesions and haemorrhages on mRI at 1month in patients commenced on early(mic lesions and more haemorrhages in the early anticoagulant group at 1-month *** A prospective multicentre,observational cohort study was performed at 11 Australian stroke *** and mRI data were collected at baseline and follow-up,with blinded imaging assessment performed by two *** of commencement of anticoagulation was at the discretion of the treating stroke *** We recruited 276 patients of whom 208 met the eligibility *** average age was 74.2 years(SD±10.63),and 79(38%)patients were *** National Institute of Health Stroke Scale score was 5(IQR 1–12).median baseline ischaemic lesion volume was 5mL(IQR 2–17).There were a greater number of new ischaemic lesions on follow-up mRI in patients commenced on anticoagulation≥4days after index event(17%vs 8%,p=0.04),but no difference in haemorrhage rates(22%vs 32%,p=0.10).Baseline ischaemic lesion volume of≤5mL was less likely to have a new haemorrhage at 1month(p=0.02).There was no difference in haemorrhage rates in patients with an initial ischaemic lesion volume of>5mL,regardless of anticoagulation *** Commencing anticoagulationmic lesions at 1month in AF *** is no increased rate of haemorrhage with early *** results suggest that early anticoagulation after mild-to-moderate acute ischaemic stroke associated w

关键词： patients lesions ischaemic

Storylines of family medicine Ⅳ:perspectives on practice—lenses of appreciation

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Family medicine and Community Health 2024年第S3期12卷 33-42页

作者： William B Ventres Leslie A Stone Radeeb Akhtar Jeffrey m Ring Lucy m Candib Erick messias Ronald m Epstein marc Tunzi Amy L Lee Christopher P morley Carina m Brown David Slawson Jill Konkin David G Campbell Ian Couper susan Williams Robert Brooks Lucie Walters Family and Preventive medicine University of Arkansas for Medical Sciences College of MedicineLittle RockArkansasUSA Family medicine and Community Health Icahn School of Medicine at Mount SinaiNew YorkNew YorkUSA Independent Health Psychologist Los AngelesCaliforniaUSA Family medicine and Community Health UMass Chan Medical SchoolWorcesterMassachusettsUSA Psychiatry and Behavioral Neurosciences Saint Louis University School of MedicineSaint LouisMissouriUSA Family medicine University of Rochester Medical CenterRochesterNew YorkUSA Family medicine Residency Program Natividad Medical CenterSalinasCaliforniaUSA Family medicine Tufts University School of MedicineBostonMassachusettsUSA Public Health and Preventive medicine SUNY Upstate Medical UniversitySyracuseNew YorkUSA Cone Health Family medicine Residency The University of North Carolina School of MedicineGreensboroNorth CarolinaUSA Family medicine Atrium HealthCharlotteNorth CarolinaUSA Family medicine University of Alberta Faculty of Medicine&DentistryEdmontonAlbertaCanada Cunninghame Arm medical Centre Australian College of Rural and Remote MedicineLakes EntranceQueenslandAustralia Ukwanda Centre for Rural Health Stellenbosch University Faculty of Medicine and Health SciencesCape TownWestern CapeSouth Africa Adelaide Rural Clinical School The University of AdelaideAdelaideSouth AustraliaAustralia Department of Rural Health Broken Hill UniversityBroken HillNew South WalesAustralia Adelaide Rural Clinical School The University of Adelaide Faculty of Health and Medical SciencesMount GambierSouth AustraliaAustralia

Storylines of Family medicine is a 12-part series of thematically linked mini-essays with accompanying illustrations that explore the many dimensions of family medicine,as interpreted by individual family physicians and medical educators in the USA and elsewhere around the ***‘Ⅳ:perspectives on practice—lenses of appreciation’,authors address the following themes:‘Relational connections in the doctor–patient partnership’,‘Feminism and family medicine’,‘Positive family medicine’,‘mindful practice’,‘The new,old ethics of family medicine’,‘Public health,prevention and populations’,‘Information mastery in family medicine’and‘Clinical courage.’may readers nurture their curiosity through these essays.

关键词： thematic illustration doctor

Current and near-term advances in Earth observation for ecological applications

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Ecological Processes 2021年第1期10卷 1-57页

作者： susan L.Ustin Elizabeth m.middleton John muir Institute of the Environment University of CaliforniaDavisCA 95616USA NASA/Goddard Space Flight Center(Emerita) GreenbeltMD 20771USA.

There is an unprecedented array of new satellite technologies with capabilities for advancing our understanding of ecological processes and the changing composition of the Earth’s biosphere at scales from local plots to the whole *** identified 48 instruments and 13 platforms with multiple instruments that are of broad interest to the environmental sciences that either collected data in the 2000s,were recently launched,or are planned for launch in this *** have restricted our review to instruments that primarily observe terrestrial landscapes or coastal margins and are available under free and open data *** focused on imagers that passively measure wavelengths in the reflected solar and emitted thermal *** suite of instruments we describe measure land surface characteristics,including land cover,but provide a more detailed monitoring of ecosystems,plant communities,and even some species then possible from historic *** newer instruments have potential to greatly improve our understanding of ecosystem functional relationships among plant traits like leaf mass area(LmA),total nitrogen content,and leaf area index(LAI).They provide new information on physiological processes related to photosynthesis,transpiration and respiration,and stress detection,including capabilities to measure key plant and soil biophysical *** include canopy and soil temperature and emissivity,chlorophyll fluorescence,and biogeochemical contents like photosynthetic pigments(e.g.,chlorophylls,carotenoids,and phycobiliproteins from cyanobacteria),water,cellulose,lignin,and nitrogen in foliar *** data will enable us to quantify and characterize various soil properties such as iron content,several types of soil clays,organic matter,and other *** of these satellites are in low Earth orbit(LEO),but we include a few in geostationary orbit(GEO)because of their potential to measure plant physiological traits over diurnal periods,impro

关键词： Terrestrial ecosystems Earth Observing Satellites Ecosystem processes Physiological functions multispectral Hyperspectral Thermal LiDAR Radar imagers Biochemistry Soil properties Species mapping Change detection 3D canopy structure Topography

Biased activity of soluble guanylyl cyclase:the Janus face of thymoquinone

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Acta Pharmaceutica Sinica B 2017年第4期7卷 401-408页

作者： Charlotte Detremmerie Paul m.Vanhoutte susan Leung Department of Pharmacology and Pharmacy and State Key Laboratory for Pharmaceutical Biotechnology Li Ka Shing Faculty of Medicinethe University of Hong KongHong KongChina

The natural compound thymoquinone, extracted from Nigella sativa(black cumin), is widely used in humans for its anti-oxidative properties. Thymoquinone is known for its acute endotheliumindependent vasodilator effects in isolated rat aortae and pulmonary arteries, depending in part on activation of adenosine triphosphate-sensitive potassium channels and inhibition of voltage-dependent calcium channels. The compound also improves endothelial dysfunction in mesenteric arteries of ageing rodents and in aortae of rabbits treated with pyrogallol, by inhibiting oxidative stress. Serendipitously,thymoquinone was found to augment contractions in isolated arteries with endothelium of both rats and pigs. The endothelium-dependent augmentation it causes counterintuitively depends on biased activation of soluble guanylyl cyclase(sGC) producing inosine 3',5'-cyclic monophosphate(cyclic ImP) rather than guanosine 3',5'-cyclic monophosphate. This phenomenon shows a striking mechanistic similarity to the hypoxic augmentation previously observed in porcine coronary arteries. The cyclic ImP preferentially produced under thymoquinone exposure causes an increased contractility of arterial smooth muscle by interfering with calcium homeostasis. This brief review summarizes the vascular pharmacology of thymoquinone, focussing in particular on how the compound causes endothelium-dependent contractions by biasing the activity of sGC.

关键词： Thymoquinone Endothelium-dependentcontraction Nitric oxide Soluble guanylyl cyclase Cyclic ImP NADPH:quinone oxidoreductase