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Managing end-stage carcinoid heart disease:A case report and literature review

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World Journal of Gastrointestinal Oncology 2024年第3期16卷 1076-1083页

作者： nikola Bulj Vedran Tomasic Maja Cigrovski Berkovic Department of Cardiology University Hospital Centre“Sestre Milosrdnice“Zagreb 10000Croatia Division of Gastroenterology Department of Internal MedicineUniversity Hospital Centre“Sestre Milosrdnice”Zagreb 10000Croatia Department for Sport and Exercise Medicine University of Zagreb Faculty of KinesiologyZagreb 10000Croatia

BACKGROUND Gastroenteropancreatic neuroendocrine neoplasms(GEP-NENs)are rare tumors,often diagnosed in an advanced stage when curative treatment is impossible and grueling symptoms related to vasoactive substance release by tumor cells affect patients’quality of *** complications of GEP-NENs,primarily tricuspid and pulmonary valve disease,and right-sided heart failure,are the leading cause of death,even compared to metastatic *** SUMMARY We present a case of a 35-year-old patient with progressive dyspnea,back pain,polyneuropathic leg pain,and nocturnal diarrhea lasting for a decade before the diagnosis of neuroendocrine carcinoma of unknown primary with extensive liver *** the initial presentation,serum biomarkers were not evaluated,and the patient received five cycles of doxorubicin,which he did not tolerate well,so he refused further therapy and was lost to *** 10 years,he presented to the emergency room with signs and symptoms of right-sided heart *** markers,serum chromogranin A,and urinary 5-hydroxyindoleacetic acid were extremely elevated(900 ng/mL and 2178µmol/L),and transabdominal ultrasound confirmed hepatic *** tomo-graphy(CT)showed liver metastases up to 6 cm in diameter and metastases in mesenteric lymph nodes and ***,an Octreoscan showed lesions in the heart,thoracic spine,duodenum,and ascendent colon.A standard trans-thoracic echocardiogram confirmed findings of carcinoid heart *** patient was not a candidate for valve *** started octreotide acetate treatment,and the dose escalated to 80 mg IM *** biochemical CONCLUSION Carcinoid heart disease occurs with carcinoid syndrome related to advanced neuroendocrine tumors,usually with liver metastases,which manifests as right-sided heart valve dysfunction leading to right-sided heart *** heart disease and tumor burden are major prognostic factors of poor surviva

关键词： Gastroenteropancreatic neuroendocrine neoplasms Carcinoid syndrome Carcinoid heart disease Diagnosis Treatment Case report

An in vitro demonstration of a passive,acoustic metamaterial as a temperature sensor with mK resolution for implantable applications

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Microsystems & Nanoengineering 2024年第1期10卷 41-54页

作者： Lucrezia Maini Vicente Genovés Roman Furrer nikola Cesarovic Christofer Hierold Cosmin Roman Micro-and Nanosystems Department of Mechanical and Process EngineeringETH ZurichTannenstrasse 38092 ZurichSwitzerland. Translational Cardiovascular Technology Department of Health Science and TechnologyETH ZurichLeopold-Ruzicka-Weg 48093 ZurichSwitzerland. Transport at Nanoscale Interfaces Swiss Federal Laboratories for Materials Science and TechnologyEMPAÜberlandstrasse 1298600 DübendorfSwitzerland Department of Cardiothoracic and Vascular Surgery Deutsches Herzzentrum der Charite(DHZC)13353 BerlinGermany

Wireless medical sensors typically utilize electromagnetic coupling or ultrasound for energy transfer and sensor *** transfer and management is a complex aspect that often limits the applicability of implantable sensor *** this work,we report a new passive temperature sensing scheme based on an acoustic metamaterial made of silicon embedded in a polydimethylsiloxane *** to other approaches,this concept is implemented without additional electrical components in situ or the need for a customized receiving unit.A standard ultrasonic transducer is used for this demonstration to directly excite and collect the reflected *** metamaterial resonates at a frequency close to a typical medical value(5 MHz)and exhibits a high-quality *** the design features of the metamaterial with the high-temperature sensitivity of the polydimethylsiloxane matrix,we achieve a temperature resolution of 30 *** value is below the current standard resolution required in infrared thermometry for monitoring postoperative complications(0.1 K).We fabricated,simulated,in vitro tested,and compared three acoustic sensor designs in the 29-43℃(~302-316 K)temperature *** this concept,we demonstrate how our passive metamaterial sensor can open the way toward new zero-power smart medical implant concepts based on acoustic interrogation.

关键词： passive resolution utilize

Rethinking Global Context in Crowd Counting

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Machine Intelligence Research 2024年第4期21卷 640-651页

作者： Guolei Sun Yun Liu Thomas Probst Danda Pani Paudel nikola Popovic Luc Van Gool Computer Vision Lab ETH ZürichZürich 8092Switzerland Institute for Infocomm Research A*STARSingapore 138632Singapore Magic Leap Zürich 8050Switzerland

This paper investigates the role of global context for crowd ***,a pure transformer is used to extract features with global information from overlapping image *** by classification,we add a context token to the input sequence,to facilitate information exchange with tokens corresponding to image patches throughout transformer *** to the fact that transformers do not explicitly model the tried-and-true channel-wise interactions,we propose a token-attention module(TAM)to recalibrate encoded features through channel-wise attention informed by the context *** that,it is adopted to predict the total person count of the image through regression-token module(RTM).Extensive experiments on various datasets,including ShanghaiTech,UCFQNRF,JHU-CROWD++and NWPU,demonstrate that the proposed context extraction techniques can significantly improve the performanceover the baselines.

关键词： Crowd counting vision transformer global context attention density map.

Treatment endpoints in ulcerative colitis:Does one size fit all?

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World Journal of Gastrointestinal Pharmacology and Therapeutics 2024年第2期15卷 1-12页

作者： nikola Mitrev Viraj Kariyawasam Department of Gastroenterology Blacktown HospitalBlacktown 2148NSWAustralia Blacktown/Mt Druitt Clinical School University of Western SydneyBlacktown 2148NSWAustralia Department of Gastroenterology Wollongong HospitalLoftus StWollongong 2500NSWAustralia

A treat-to-target strategy in inflammatory bowel disease(IBD)involves treatment intensification in order to achieve a pre-determined *** uniform and tight disease control has been demonstrated to improve clinical outcomes compared to treatment driven by a clinician’s subjective assessment of ***,choice of treatment endpoints remains a challenge in management of IBD via a treat-to-target *** treatment endpoints for ulcerative colitis(UC),recommended by the Selecting Therapeutic Targets in Inflammatory Bowel Disease(STRIDE)consensus have changed somewhat over *** latest STRIDE-II consensus advises immediate(clinical response),intermediate(clinical remission and biochemical normalisation)and long-term treatment(endoscopic healing,absence of disability and normalisation of health-related quality of life,as well as normal growth in children)endpoints in ***,achieving deeper levels of remission,such as histologic normalisation or healing of the gut barrier function,may further improve outcomes among UC ***,all medical therapy should seek to improve short-and long-term mortality and *** treatment endpoints should be chosen based on their ability to predict for improvement in short-and long-term mortality and *** benefits of treatment intensification need to be weighed against the potential harms within an individual *** addition,changing therapy that has achieved partial response may lead to worse outcomes,with failure to recapture response on treatment *** may also place different emphasis on certain potential benefits and harms of various treatments than clinicians,or may have strong opinions re certain *** benefits and harms of therapies,incremental benefits of achieving deeper levels of remission,as well as uncertainties of the same,need to be discussed with individual patients,and a treatment endpoint agreed upon with the *** resear

关键词： Ulcerative colitis Treatment endpoints Endoscopic remission Histologic remission Biomarkers Gut barrier healing

Two big orifices in the second duodenal portion:A case of an atypical double papilla

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Hepatobiliary & Pancreatic Diseases International 2024年第1期23卷 83-85页

作者： Salvatore Francesco Vadalàdi Prampero nikola Panic Marco Massidda Chiara Rocchi Pierluigi Maria Rinaldi Ana Malenkovic Milutin Bulajic Gastroenterology and GI Endoscopy Department Mater Olbia HospitalOlbia 07026Italy Digestive Endoscopy Unit University Clinic"Dr Dragisa Misovic-Dedinje"Belgrade 11000Serbia Radiology Department Mater Olbia HospitalOlbia 07026Italy

With the advent of endoscopic retrograde cholangiopancreatography(ERCP)in the early 1970s,anatomic anomalies of the Vaterian system were described endoscopically[1].Although the occurrence is rare,the common bile duct(CBD)and the pancreatic duct may fail to coalesce during embryologic *** leads to double major papilla because both ducts open into the duodenum separately[1].In this way the cranial duct communicates with the CBD,while the caudal orifice communicates with the pancreatic duct[2].

关键词： orifice Vater atypical

Role of copper chelating agents: between old applications and new perspectives in neuroscience

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Neural Regeneration Research 2025年第3期20卷 751-762页

作者： Rosalba Leuci Leonardo Brunetti Vincenzo Tufarelli Marco Cerini Marco Paparella nikola Puvača Luca Piemontese Department of Pharmacy-Pharmaceutical Science University of Bari Aldo MoroBariItaly Department of Precision and Regenerative Medicine and Jonian Area(DiMePRe-J) Section of Veterinary Science and Animal ProductionUniversity of Bari Aldo MoroBariItaly Department of Engineering Management in Biotechnology Faculty of Economics and Engineering Management in Novi SadUniversity Business Academy in Novi SadNovi SadSerbia

The role of copper element has been an increasingly relevant topic in recent years in the fields of human and animal health, for both the study of new drugs and innovative food and feed supplements. This metal plays an important role in the central nervous system, where it is associated with glutamatergic signaling, and it is widely involved in inflammatory processes. Thus, diseases involving copper(Ⅱ) dyshomeostasis often have neurological symptoms, as exemplified by Alzheimer's and other diseases(such as Parkinson's and Wilson's diseases). Moreover, imbalanced copper ion concentrations have also been associated with diabetes and certain types of cancer, including glioma. In this paper, we propose a comprehensive overview of recent results that show the importance of these metal ions in several pathologies, mainly Alzheimer's disease, through the lens of the development and use of copper chelators as research compounds and potential therapeutics if included in multi-target hybrid drugs. Seeing how copper homeostasis is important for the well-being of animals as well as humans, we shortly describe the state of the art regarding the effects of copper and its chelators in agriculture, livestock rearing, and aquaculture, as ingredients for the formulation of feed supplements as well as to prevent the effects of pollution on animal productions.

关键词： agriculture Alzheimer's disease chelators copper feed supplements multi-target

Evaluation of disease burden and symptom scores in patients with acute atrial fi brillation in the emergency department

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World Journal of Emergency Medicine 2024年第5期15卷 397-400页

作者： nikola Schütz Dominik Roth Michael Prinz Filippo Cacioppo Sebastian Schnaubelt Alexander O.Spiel Hans Domanovits Harald Herkner Department of Emergency Medicine Medical University of ViennaVienna 1090Austria Department of Emergency Medicine Clinic OttakringVienna 1160Austria

Atrial fibrillation(AF)is a major public health problem and poses a substantial economic burden on healthcare systems worldwide.[1-4]The emergency department(ED)serves as the first point of contact with the healthcare system and plays a key role in the management of patients with AF,which accounts for 3%-10%of all hospital admissions.[5]Treatment plans are often discussed and initiated at the ED.

关键词： patients atrial acute

Pharmacological methods for ovarian function and fertility preservation in women with cancer:A literature review

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Oncology Research 2024年第8期32卷 1309-1322页

作者： ANA S.CVETANOVIC MATTEO LAMBERTINI KEVIN PUNIE GORANA G.MATOVINA BRKO nikola D.ZIVKOVIC MAJA J.POPOVIC MARIJANA M.MILOVIC KOVACEVIC LAZAR S.POPOVIC Department for Oncology Medical Faculty NisUniversity of NisNis18000Serbia Clinic of Oncology University Clinical Centre NisNis18000Serbia Department of Internal Medicine and Medical Sciences(DiMI) School of MedicineUniversity of GenovaGenova16100Italy Department of Medical Oncology U.O.C Clinica di Oncologia MedicaIRCCS Ospedale Policlinico San MartinoGenova16100Italy Department of General Medical Oncology and Multidisciplinary Breast Centre Leuven Cancer InstituteUniversity Hospitals LeuvenLeuven3001Belgium Department of Medical Oncology Oncology Institute of VojvodinaSremska Kamenica21208Serbia Department for Pathology Medical Faculty NisUniversity of NisNis18000Serbia Center for Pathology University Clinical Centre NisNis18000Serbia Faculty of Medicine University of Novi SadNovi Sad21000Serbia Department of Medical Oncology Institute of Oncology and Radiology SerbiaBelgrade11000Serbia

Oncofertility is an extremely signiﬁcant topic that is increasingly being discussed owing to increased evidence indicating that fertility preservation does not affect the treatment outcomes of patients with cancer but signiﬁcantly contributes to preserving life *** effect of chemotherapy can range from minimal effects to complete ovarian *** data are available on the effects of monoclonal antibodies and targeted therapies on the ovaries and *** ovarian suppression by administering a gonadotropin-releasing hormone agonist(GnRHa)during chemotherapy decreases the gonadotoxic effect of chemotherapy,thereby diminishing the chance of developing premature ovarian insufﬁciency(POI).At present,the concomitant administration of GnRH analogs during chemotherapy is the only accepted pharmacological method for preserving ovarian ***,most randomized studies on the effectiveness of luteinizing hormone-releasing hormone agonists during chemotherapy in preventing POI have been conducted in women with breast cancer,with a considerably small number of studies on patients with hematological ***,most randomized controlled trials on breast cancer have revealed a decrease in treatment-induced POI risk,regardless of the hormone receptor *** addition,studies on hematological malignancies have yielded negative results;nevertheless,theﬁndings must be interpreted with caution owing to numerous *** guidelines from the American Society of Clinical Oncology and ESMO Clinical Practice Guidelines recommend sperm,oocyte,and embryo cryopreservation as a standard practice and only offering GnRHa to patients when proven fertility preservation methods are not *** this manuscript,we present a comprehensive literature overview on the application of ovarian suppression with GnRHa during chemotherapy in patients with cancer by addressing preclinical and clinical data,as well as future perspectives in thisﬁeld

关键词： Gonadotropin-releasing hormone agonists(GnRHa) Fertility preservation Premature ovarian insufficiency(POI) Premenopausal patients

Prehospital transdermal glyceryl trinitrate for ultra- acute ischaemic stroke: data from the RIGHT- 2 randomised sham- controlled ambulance trial

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Stroke & Vascular Neurology 2024年第1期9卷 38-49,I0035-I0046页

作者： Jason Philip Appleton Lisa J Woodhouse Craig S Anderson Sandeep Ankolekar Lesley Cala Mark Dixon Timothy J England Kailash Krishnan Grant Mair Keith W Muir John Potter Christopher I Price Marc Randall Thompson G Robinson Christine Roffe Else C Sandset Jeffrey L Saver Angela Shone Aloysius Niroshan Siriwardena Joanna M Wardlaw nikola Sprigg Philip M Bath Stroke University Hospitals Birmingham NHS Foundation TrustBirminghamUK Institute of Applied HealthResearch University of Birmingham College of Medical and Dental SciencesBirminghamUK Stroke Trials Unit Mental Health and Clinical NeurosciencesUniversity of NottinghamNottinghamUK Faculty of Medicine The George Institute for Global HealthSydneyNew South WalesAustralia The George Institute China at Peking University Health Science Center BeijingChina Neurology Royal Prince Alfred HospitalSydney Health PartnersSydneyNew South WalesAustralia Department of Neurology King's College Hospital NHS Foundation TrustLondonUK Faculty of Health and Medical Sciences University of Western AustraliaCrawleyWestern AustraliaAustralia East Midlands Ambulance Service NHS Trust NottinghamUK Stroke Queen's Medical CentreNottingham University Hospitals NHS TrustNottinghamUK Centre for Clinical Brain Sciences Dementia Research InstituteUniveristy of EdinburghEdinburghUK Institute of Neurology and Psychology University of GlasgowGlasgowUK Bob Champion Research and Education Building University of East AngliaNorwichUK Institute of Neuroscience Newcastle UniversityNewcastle upon TyneUK Department of Neurology Leeds Teaching Hospitals NHS TrustLeedsUK Department of Cardiovascular Sciences and NIHR Leicester Biomedical Research Centre University of LeicesterLeicesterUK Stroke Research in Stoke Institute for Science and Technology in MedicineKeele UniversityStoke-on TrentUK Department of Neurology Oslo University HospitalOsloNorway Research and Development Norwegian Air Ambulance FoundationOsloNorway Department of Neurology and Comprehensive Stroke Center David Geffen School of MedicineUCLALos AngelesCaliforniaUSA Research and Graduate Services University of NottinghamNottinghamUK Community and Health Research Unit University of LincolnLincolnUK

Background The effect of transdermal glyceryl trinitrate(GTN,a nitrovasodilator)on clinical outcome when administered before hospital admission in suspected stroke patients is ***,we assess the safety and efficacy of GTN in the prespecified subgroup of patients who had an ischaemic stroke within the Rapid Intervention with Glyceryl trinitrate in Hypertensive stroke Trial-2(RIGHT-2).Methods RIGHT-2 was an ambulance-based multicentre sham-controlled blinded-endpoint study with patients randomised within 4hours of *** primary outcome was a shift in scores on the modified Rankin scale(mRS)at day *** outcomes included death;a global analysis(Wei-Lachin test)containing Barthel Index,EuroQol-5D,mRS,telephone interview for cognitive status-modified and Zung depression scale;and neuroimaging-determined‘brain frailty’*** were reported as n(%),mean(SD),median[IQR],adjusted common OR(acOR),mean difference or Mann-Whitney difference(MWD)with 95%*** 597 of 1149(52%)patients had a final diagnosis of ischaemic stroke;age 75(12)years,premorbid mRS>2107(18%),Glasgow Coma Scale 14(2)and time from onset to randomisation 67[45,108]***‘brain frailty’was common:median score 2[2,3](range 0–3).At day 90,GTN did not influence the primary outcome(acOR for increased disability 1.15,95%CI 0.85 to 1.54),death or global analysis(MWD 0.00,95%CI-0.10 to 0.09).In subgroup analyses,there were non-significant interactions suggesting GTN may be associated with more death and dependency in participants randomised within 1hour of symptom onset and in those with more severe *** In patients who had an ischaemic stroke,ultra-acute administration of transdermal GTN in the ambulance did not improve clinical outcomes in a population with more clinical and radiological frailty than seen in previous in-hospital *** IS ALREADY KNOWN ON THIS TOPIC⇒Transdermal glyceryl trinitrate(GTN)was associat-ed with less death and dependency in those w

关键词： Glasgow nitrate random