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Transplant-associated thrombotic microangiopathy:a rare but deadly complication post orthotopic heart transplantation

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Journal of Geriatric Cardiology 2022年第6期19卷 485-486页

作者： jose ruiz-Morales Maedeh Ganji Rohan Goswami Division of Advanced Heart Failure&Transplant Cardiology Mayo ClinicJacksonvilleFloridaUSA Cardiology Department University of FloridaJacksonvilleFloridaUSA

Thrombotic microangiopathy(TMA)is potentially life-threatening condition caused by small-vessel microthrombi and is associated with schistocyte formation,low platelets and end-organ damage that may not be reversible.[1,2]As a life-threatening condition,TMA recognition in hospitalized patients after organ transplantation is key to improving survival.Transplant-associated TMA(TATMA)can occur after both solid organ or hematopoietic stem cell transplantation and often mimics other disease processes such as thrombotic throm-bocytopenic purpura(TTP)with similar constellation of symptoms during presentation.We present a rare case of a patient with TATMA after orthotopic heart transplantation.

关键词： thrombotic microangiopathy orthotopic

Impact of socioeconomic and health-related factors on consumption of homeopathic and natural remedies in Spain in 2006, 2011 and 2017

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Journal of Integrative Medicine 2022年第1期20卷 52-56页

作者： jose Antonio Castilla-Jimena Isabel ruiz-Perez Jesus Henares-Montiel Andalusian School of Public Health 1801J GranadaSpain Unit of Clinical Management of Preventive Medicine and Public Health and Occupational Medicine Puerto del Mar University Hospital11009 CadizSpain Consortium for Networked Biomedical Research in Epidemiology and Public Health 28029 MadridSpain Institute for Biosanitary Research(ibs.GRANADA) 18012 GranadaSpain

Objective: Complementary and alternative medicine use and type of use may be influenced by sociodemographic and economic determinants through which we could identify characteristics of patients with greater trend to use it. This paper aims to describe the changes in the consumption of homeopathic and natural remedies in Spain for three time points in order to discern changes in rate of consumption, associated factors and whether their use has been affected by a period of economic recession.Methods: This study utilized 2006, 2011 and 2017 cross-sectional data from the Spanish National Health Survey, a nationally representative survey of the population aged more than 15 years old and resident in Spain. Independent bivariate and multivariate descriptive analyses for each of the 3 years studied were performed.Results: The rate of consumption of both homeopathic and natural remedies has decreased over the periods studied. In spite of this decrease, the consumer profile appears to remain stable over the three periods. The sociodemographic factors associated with their consumption were being female, being 30–64 years old, being separated/divorced, having higher education qualifications, being employed and belonging to a higher social class. Psychiatric morbidity, chronic health problems such as pain, mental health problems or malignant tumors, and absence of major cardiovascular events were the clinical factors associated.Conclusion: It can be concluded that beyond the economic situation, the use of homeopathic and natural remedies obeys to the needs of the patients related to their state of health and the response they receive from the health system. It may be that women have different needs and expectations of the healthcare system and, given this breach of expectations, seek remedy to alleviate their needs outside the system and conventional medicine.

关键词： Complementary and alternative medicine Homeopathic remedies Natural remedies Economic recession Gender differences

Integrity and resilience in the face of multiple crises:commentary from Puerto Rico

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Forensic Sciences Research 2021年第3期6卷 316-319页

作者： Richard J.Noel Jr jose A.Torres-ruiz Department of Basic Sciences School of MedicinePonce Health Sciences UniversityPoncePRUSA Office of the Chancellor Ponce Health Sciences UniversityPoncePRUSA

Since 2010,the population of Puerto Rico has declined by 11.8%and is currently 3.3 million peo-ple[1].This worrisome trend is a result of a pleth-ora of island-wide challenges spanning financial difficulties,natural disasters,and epidemics.Following over a decade of economic hardship and debt,incapacitating hurricanes,Irma and Maria,destroyed large swaths of the island in 2017.While still recovering from that disaster,a magnitude 6.4 earthquake centered about 5 miles off the south-western coast on January 7,2020,destroying build-ings and roads in southwestern Puerto Rico.This event,and subsequent aftershocks that continue until today,further aggravate an already stressed popula-tion.In the mix,viral epidemics have brought fur-ther economic,social,and health-related suffering.Puerto Rico was the centre of the 2016-2017 Zika virus infections,representing over 85%of the US infections in 2016[2].

关键词： island disaster southwestern

Recurrent ventricular tachycardia secondary to severe coronary artery ectasia

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Journal of Geriatric Cardiology 2020年第10期17卷 647-648页

作者： William Kogler jose ruiz Maedeh Ganji Ismael Ortiz Department of Internal Medicine University of Florida College of Medicine-JacksonvilleFloridaUSA Department of Cardiology University of Florida College of Medicine-JacksonvilleFloridaUSA

A 64-year-old male with a history of thoracic aortic ulcer s/p thoracic endovascular aortic repair presented to the hospital with typical chest pain.His initial physical exam was unremarkable.Cardiac biomarkers were n... 详细信息

关键词： Coronary artery ectasia

Acute lymphocytic myocarditis

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Journal of Geriatric Cardiology 2018年第7期15卷 527-528页

作者： Maedeh Ganji jose ruiz-Morales Saif Ibrahim Cardiology Department University of Florida Jacksonville FL USA Internal Medicine Department University of Florida Jacksonville FL USA Interventional Cardiology Department University of Alabama-Birmingham Birmingham AL USA

Myocarditis is an inflammatory disease of the myocardium.The clinical presentation of myocarditis may range from subclinical to sudden death.The incidence of fatal myocarditis,which often presents with sudden or rapid death,has been estimated at 0.15/100.000 in the general population and is highest in infants and young adults (but may affect any age group).However,diffuse myocarditis in autopsies of sudden death is< 2% in adult.Myocarditis usually presents with heart failure symptoms over a few days to weeks.The classic presentation of viral myocarditis includes a viral prodrome with fever,myalgia,and upper respiratory symptoms.Patients present with dyspnea,chest pain,and arrhythmias.ECG abnormalities are often present,along with evidence of myocardial damage with elevated troponin levels.We present the case of a 78-year old white male who died from acute cardiac decompensation from diffuse acute lymphocytic myocarditis.

关键词：心肌炎淋巴球临床症状成年人死亡年龄组

Experimental study on lightweight expanded clay at particle level:Breakage of isolated grains

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Journal of Rock Mechanics and Geotechnical Engineering 2023年第7期15卷 1846-1858页

作者： Elías Roces-Alonso jose Estaire Miriam Martín-ruiz Jesús González-Galindo ETS de Ingenieros de Caminos Universidad Politécnica de MadridSpain Laboratorio de Geotecnia CEDEXMadridSpain

In this study,more than 1500 particles of lightweight expanded clay aggregate(LECA)are individually loaded up to breakage,following different patterns of contact(from 2 to 7)using a purpose-built apparatus.Consequently,a statistical model for predicting the number of fragments into which a grain breaks as a function of the number of contacts and their diameter is proposed.The number of fragments is found to follow a statistical binomial-type distribution function that depends on the number of contacts.In addition,a model based on Bayesian networks,capable of assessing the number of fragments and their size(measured as normalized weight)as a function of the number of contacts,is implemented.The proposed method is applicable when performing discrete element method(DEM)simulations on granular media in which grain breakage plays a relevant role.

关键词： Lightweight expanded clay aggregate(LECA) Grain fragmentation Grain breakage Biaxial grain load

Coxsackievirus B infection presenting as a hemorrhagic pericardial effusion causing tamponade

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Journal of Geriatric Cardiology 2020年第10期17卷 642-644页

作者： Fadi Kandah Pooja Dhruva jose ruiz Andres Martinez William Kogler Internal Medicine University of Florida Health JacksonvilleJacksonvilleUSA

The coxsackievirus is well known for its vastly differing clinical presentations.Patients with coxsackievirus usually present with a viral prodrome which can then progress to the cardiac symptoms of chest pain and/or palpitations.Most patients improve quickly with simply supportive care and nonsteroidal anti-inflammatory medications.

关键词： Cardiac tamponade Coxsackievirus Pericarditis

A case series of precipitous cardiac tamponade from suspected perimyocarditis in COVID-19 patients

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Journal of Geriatric Cardiology 2021年第5期18卷 403-406,I0002-I0004页

作者： William Kogler Michael Omar Naji Maaliki Shaorinkumar Patel Sam Foldy jose ruiz Department of Internal Medicine University of Florida JacksonvilleJacksonvilleFLUSA Department of Cardiology University of Florida JacksonvilleFLUSA

A 71yearold well controlled hypertensive female presented on day 4 of acute COVID19 illness with atypical chest pain and worsening exertional dyspnea.On examination,heart rate was 110 beats/min,blood pressure was 125/82 mmHg and there were decreased heart sounds with visible jugular venous distention.She was not in respiratory distress at rest and was not requiring supplemental oxygen.Chest radiography showed bilateral diffuse opacities(Figure 1).transthoracic echocardiography(TTE)confirmed a moderate pericardial effusion with right ventricular systolic compression,paradoxical right ventricular septal motion,enddiastolic right atrial collapse,and a plethoric inferior vena cava(IVC)with no respiratory variation.Her ejection fraction(EF)was 55%.Initial workup revealed mildly elevated troponin T levels of 0.14 ng/mL,NTPro BNP of 2500 pg/mL.

关键词： hypertensive distress elevated

Left ventricular non-compaction presenting as cardio-embolic stroke

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Journal of Geriatric Cardiology 2020年第10期17卷 645-646页

作者： Andres Martinez Michael Omar Fadi Kandah jose ruiz Ahsan Niazi Department of Internal Medicine University of Florida College of Medicine-JacksonvilleFloridaUSA Department of Cardiology University of Florida College of Medicine-JacksonvilleFloridaUSA Department of Neurology University of Florida College of Medicine-JacksonvilleFloridaUSA

A 39-year-old male with no known comorbidities presented with sudden onset right-sided weakness.On examination,blood pressure was 128/79 mmHg,National Institutes of Health Stroke Scale score was 4 and there were no signs of heart failure.Emergent computerized tomography demonstrated an ischemic infarct of the left middle cerebral artery distribution and brain magnetic resonance imaging later confirmed it(Figure 1).

关键词： Cardio-embolic Cardiomyopathy Non-compaction Trabeculae