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Immunoglobulin A glomerulonephropathy:A review

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World Journal of Clinical Cases 2024年第8期12卷 1388-1394页

作者： Mohamad El Labban salim Surani Department of Internal Medicine Mayo Cliic Health SystemMankatoMN 56001United States Department of Medicine&Pharmacology Texas A&M UniversityCollege StationTX 77843United State

In this editorial,we comment on the article by Meng et al published in the World Journal of Clinical Cases.We comprehensively review immunoglobulin A nephro-pathy(IgAN),including epidemiology,clinical presentation,diagnosis,and management.IgAN,also known as Berger's disease,is the most frequent type of primary glomerulonephritis(GN)globally.It is mostly found among the Asian population.The presentation can be variable,from microscopic hematuria to a rapidly progressive GN.Around 50%of patients present with single or recurring episodes of gross hematuria.An upper respiratory infection and tonsillitis often precede these episodes.Around 30%of patients present microscopic hematuria with or without proteinuria,usually detected on routine examination.The diagnosis relies on having a renal biopsy for pathology and immunofluorescence microscopy.We focus on risk stratification and management of IgAN.We provide a review of all the landmark studies to date.According to the 2021 KDIGO(kidney disease:Improving Global Outcomes)guidelines,patients with non-variant form IgAN are first treated conservatively for three to six months.This approach consists of adequate blood pressure control,reduction of proteinuria with renin-angiotensin system blockade,treatment of dyslipidemia,and lifestyle modifications(weight loss,exercise,smoking cessation,and dietary sodium restrictions).Following three to six months of conservative therapy,patients are further classified as high or low risk for disease progression.High-risk patients have proteinuria≥1 g/d or<1 g/d with significant microscopic hematuria and active inflammation on kidney biopsy.Some experts consider proteinuria≥2 g/d to be very high risk.Patients with high and very high-risk profiles are treated with immunosuppressive therapy.A proteinuria level of<1 g/d and stable/im-proved renal function indicates a good treatment response for patients on immu-nosuppressive therapy.

关键词： Immunoglobulin A nephropathy Glomerulonephritis Nephritic syndrome Angiotensin-converting enzyme inhibitor Angiotensin receptor blocker Systemic steroids Mycophenolate mofetil

Early antiplatelet therapy used for acute ischemic stroke and intracranial hemorrhage

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World Journal of Clinical Cases 2024年第4期12卷 677-680页

作者： Venkata Buddhavarapu Rahul Kashyap salim Surani Department of Medicine Banner Baywood Medical CenterMesaAZ 85206United States Department of Research Wellspan HealthYorkPA 17403United States Department of Medicine&Pharmacology Texas A&M UniversityCollege StationTX 77843United States

In this editorial we comment on the article published by Zhang et al in the recent issue of World Journal of Clinical Cases.We evaluate their claims on the benefit of use of Aspirin in the early management of patients with ischemic stroke.We also comment on their contention of using aspirin in the early management of patients with intracranial hemorrhage,a practice not seen in modern medicine.Large clinical trials such as the International Stroke Trial and the Chinese Acute Stroke Trial have shown the benefit of Aspirin use within 48 h of patients with Acute Ischemic Stroke.The findings were corroborated in the open-label trial performed by Zhang et al in a smaller sample group of 25 patients where they showed improvement in functional scores at 90 days without an increase in adverse events.As such,this intervention is also recommended by the American Heart Association stroke guidelines from 2021.With regard to Intracranial hemorrhage,traditional practice has been to discontinue or avoid antiplatelet therapy in these patient groups.However,no studies have been done to evaluate this management strategy that is more borne out of the mechanism behind Aspirin’s effect on the coagulation pathway.Zhang et al evaluate the benefits of Aspirin on patients with low-volume intracranial hemorrhage,i.e.,less than 30 mL on computed tomo-graphy imaging,and show no increase in mortality.The caveat of this finding is that all outcomes were pooled into one group for results,and the number of patients was low.While more studies with larger patient groups are required,the data from Zhang et al suggests that patients with small-volume intracranial hemorrhages may benefit from Aspirin administration in the acute phase of management.

关键词： Aspirin Ischemic stroke Intracranial hemorrhage CVA Antiplatelet therapy

Investigating causal links between gastroesophageal reflux disease and essential hypertension

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World Journal of Clinical Cases 2024年第14期12卷 2304-2307页

作者： Gowthami Sai Kogilathota Jagirdhar Yatinder Bains salim Surani Department of Medicine Saint Francis Health Science CenterNewarkNJ 07107United States Department of Gastroenterology Saint Michaels Medical CenterNewarkNJ 07102United States Department of Medicine and Pharmacology Texas A&M UniversityCollege StationTX 77843United States

Gastroesophageal reflux disease(GERD)is a prevalent global health concern with a rising incidence.Various risk factors,including obesity,hiatal hernia,and smo-king,contribute to its development.Recent research suggests associations bet-ween GERD and metabolic syndrome,cardiac diseases,and hypertension(HTN).Mechanisms linking GERD to HTN involve autonomic dysfunction,inflammatory states,and endothelial dysfunction.Furthermore,GERD medications such as pro-ton-pump inhibitors may impact blood pressure regulation.Conversely,antihy-pertensive medications like beta-blockers and calcium channel blockers can exacerbate GERD symptoms.While bidirectional causality exists between GERD and HTN,longitudinal studies are warranted to elucidate the precise relationship.Treatment of GERD,including anti-reflux surgery,may positively influence HTN control.However,the interplay of lifestyle factors,comorbidities,and medications necessitates further investigation to comprehensively understand this relation-ship.In this editorial,we comment on the article published by Wei et al in the recent issue of the World Journal of Clinical Cases.We evaluate their claims on the causal association between GERD and HTN.

关键词： Gastroesophageal reflux disease Hypertension Metabolic syndrome Gastro-esophageal reflux disease Hiatal hernia

Removal of intrahepatic bile duct stone could reduce the risk of cholangiocarcinoma

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World Journal of Clinical Cases 2024年第11期12卷 1881-1884页

作者： Gowthami Sai Kogilathota Jagirdhar Yatinder Bains salim Surani Department of Medicine Saint Francis Health Science CenterNewarkNJ 07107United States Department of Gastroenteroly Saint Michaels Medical CenterNewarkNJ 07102United States Department of Medicine and Pharmacology Texas A&M UniversityCollege StationTX 77843United States

Hepatolithiasis(HL)poses a significant risk for cholangiocarcinoma(CCA)development,with reported incidences ranging from 5%-13%.Risk factors include older age,smoking,hepatitis B infection,and prolonged HL duration.Chronic inflammation and mechanical stress on the biliary epithelium contribute to CCA pathogenesis.Hepatectomy reduces CCA risk by removing stones and atrophic liver segments.However,residual stones and incomplete removal increase CCA risk.Kim et al identified carbohydrate antigen 19-9,carcinoembryonic antigen,and stone laterality as CCA risk factors,reaffirming the importance of complete stone removal.Nonetheless,challenges remain in preventing CCA recurrence post-surgery.Longer-term studies are needed to elucidate CCA risk factors further.

关键词： Hepatolithiasis Cholangiocarcinoma Biliary stone Common bile duct stone Cholangitis

Investigation of risk factors in the development of recurrent urethral stricture after internal urethrotomy

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World Journal of Clinical Cases 2024年第14期12卷 2324-2331页

作者： Abdullah Gul Ozgur Ekici salim Zengin Deniz Barali Tarik Keskin Department of Urology University of Health SciencesBursa Yüksekİhtisas Education and Research HospitalBursa 16100Türkiye Department of Urology University of Health SciencesBursa City HospitalBursa 16000Türkiye

BACKGROUND Urethral stricture is a condition that often develops with trauma and results in narrowing of the urethral lumen.Although endoscopic methods are mostly used in its treatment,it has high recurrence rates.Therefore,open urethroplasty is recommended after unsuccessful endoscopic treatments.AIM To investigate the risk factors associated with urethral stricture recurrence.METHODS The data of male patients who underwent internal urethrotomy for urethral stricture between January 2017 and January 2023 were retrospectively analyzed.Demographic data,comorbidities,preoperative haemogram,and biochemical values obtained from peripheral blood and operative data were recorded.Patients were divided into two groups in terms of recurrence development;recurrence and non-recurrence.Initially recorded data were compared between the two groups.RESULTS A total of 303 patients were included in the study.The mean age of the patients was 66.6±13.6 years.The mean duration of recurrence development was 9.63±9.84(min-max:1-39)months in the recurrence group.Recurrence did not occur in non-recurrence group throughout the follow-up period with an average time of 44.15±24.07(min-max:12-84)months.In the comparison of both groups,the presence of diabetes mellitus(DM),hypertension(HT),and multiple comorbidi-ties were significantly higher in the recurrence(+)group(P=0.038,P=0.012,P=0.013).Blood group,postoperative use of non-steroidal anti-inflammatory drugs,preoperative cystostomy,cause of stricture,iatrogenic cause of stricture,location and length of stricture,indwelling urinary cathater size and day of catheter removal did not differ between the two groups.No statistically significant difference was observed between the two groups in terms of age,uroflowmetric maximum flow rate value,hemo-gram parameters,aspartate aminotransferase(AST),alanine aminotransferase(ALT),fasting blood sugar,creati-nine,glomerular filtration rate,neutrophil-lymphocyte ratio,platelet-lymphocyte ratio,lymphocyte-monocyte ratio,monocyte-lymphocyte ratio and AST

关键词： Inflammation Internal urethrotomy Recurrence Urethral stricture Urethra

Expansion of human umbilical cord derived mesenchymal stem cells in regenerative medicine

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World Journal of Stem Cells 2024年第4期16卷 410-433页

作者： Shafiqa Naeem Rajput Bushra Kiran Naeem Anwar Ali Asmat salim Irfan Khan Dr.Panjwani Center for Molecular Medicine and Drug Research International Center for Chemical and Biological SciencesUniversity of KarachiKarachi 75270SindhPakistan Surgical Unit 4 Dr.Ruth KM Pfau Civil HospitalKarachi 74400Pakistan Department of Physiology University of KarachiKarachi 75270Pakistan Center for Regenerative Medicine and Stem Cells Research and Department of Ophthalmology and Visual SciencesThe Aga Khan UniversityKarachi 74800SindhPakistan

BACKGROUND Stem cells are undifferentiated cells that possess the potential for self-renewal with the capacity to differentiate into multiple lineages.In humans,their limited numbers pose a challenge in fulfilling the necessary demands for the regeneration and repair of damaged tissues or organs.Studies suggested that mesenchymal stem cells(MSCs),necessary for repair and regeneration via transplantation,require doses ranging from 10 to 400 million cells.Furthermore,the limited expansion of MSCs restricts their therapeutic application.AIM To optimize a novel protocol to achieve qualitative and quantitative expansion of MSCs to reach the targeted number of cells for cellular transplantation and minimize the limitations in stem cell therapy protocols.METHODS Human umbilical cord(hUC)tissue derived MSCs were obtained and re-cultured.These cultured cells were subjected to the following evaluation pro-cedures:Immunophenotyping,immunocytochemical staining,trilineage differentiation,population doubling time and number,gene expression markers for proliferation,cell cycle progression,senescence-associatedβ-galactosidase assay,human telomerase reverse transcriptase(hTERT)expression,mycoplasma,cytomegalovirus and endotoxin detection.RESULTS Analysis of pluripotent gene markers Oct4,Sox2,and Nanog in recultured hUC-MSC revealed no significant differences.The immunophenotypic markers CD90,CD73,CD105,CD44,vimentin,CD29,Stro-1,and Lin28 were positively expressed by these recultured expanded MSCs,and were found negative for CD34,CD11b,CD19,CD45,and HLA-DR.The recultured hUC-MSC population continued to expand through passage 15.Proliferative gene expression of Pax6,BMP2,and TGFb1 showed no significant variation between recultured hUC-MSC groups.Nevertheless,a significant increase(P<0.001)in the mitotic phase of the cell cycle was observed in recultured hUC-MSCs.Cellular senescence markers(hTERT expression andβ-galactosidase activity)did not show any negative effect on recultured hUC-MSCs.Additionally,quality control assessments co

关键词： Human umbilical cord Mesenchymal stem cells Expansion Cell proliferation In vitro expansion Senescence

Properties of Bark Particleboard Bonded with Demethylated Lignin Adhesives Derived from Leucaena leucocephala Bark

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Journal of Renewable Materials 2024年第4期12卷 737-769页

作者： Rafidah Md salim Jahimin Asik Mohd Sani Sarjadi Wood Testing Laboratory Faculty of Tropical ForestryUniversity of Malaysia SabahKota KinabaluSabah88400Malaysia Industrial Chemistry Program Faculty of Science and Natural ResourcesUniversity of Malaysia SabahKota KinabaluSabah88400Malaysia

Lignin extraction from bark can maximize the utilization of biomass waste,offer cost-effectiveness,and promote environmental friendliness when employed as an adhesive material in bark particleboard production.Particles of fine(0.2 to 1.0 mm),medium(1.0 to 2.5 mm),and coarse(2.5 to 12.0 mm)sizes,derived from the bark of Leucaena leucocephala,were hot-pressed using a heating plate at 175℃for 7 min to create single-layer particleboards measuring 320 mm×320 mm×10 mm,targeting a density of 700 kg/m^(3).Subsequently,the samples were trimmed and conditioned at 20℃and 65%relative humidity.In this study,we compared bark particleboard bonded with urea formaldehyde(UF)adhesive to fine-sized particleboard bonded with demethylated lignin adhesive.The results indicated that bark particleboards utilizing demethylated lignin and UF adhesives exhibited similar qualities.Coarse particleboard showed differences in modulus of elasticity(MOE)and modulus of rupture(MOR),while medium-sized particles exhibited significant variations in moisture content(MC)and water absorption(WA).Furthermore,the thickness swelling of coarse and medium-sized particles under wet and oven-dried conditions exhibited notable distinctions.Overall,the demethylated lignin adhesive extracted from L.leucocephala bark demonstrated similar quality to UF adhesive,with particle size correlating inversely to the strength of the bark particleboard.

关键词： Bark particleboard properties demethylated lignin lignin adhesives Leucaena leucocephala bark particles

21st century critical care medicine:An overview

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World Journal of Critical Care Medicine 2024年第1期13卷 1-14页

作者： Smitesh Padte Vikramaditya Samala Venkata Priyal Mehta Sawsan Tawfeeq Rahul Kashyap salim Surani Department of Research Global Remote Research Scholars ProgramSt.PaulMN 55104United States Department of Hospital Medicine Cheshire Medical Center/Dartmouth HealthKeeneNH 03431United States Department of Research WellSpan HealthYorkPA 17403United States Department of Pulmonary&Critical Care Medicine Mayo ClinicRochesterMN 55905United States Department of Medicine&Pharmacology Texas A&M UniversityCollege StationTX 77843United States

Critical care medicine in the 21st century has witnessed remarkable advancements that have significantly improved patient outcomes in intensive care units(ICUs).This abstract provides a concise summary of the latest developments in critical care,highlighting key areas of innovation.Recent advancements in critical care include Precision Medicine:Tailoring treatments based on individual patient characteristics,genomics,and biomarkers to enhance the effectiveness of therapies.The objective is to describe the recent advancements in Critical Care Medicine.Telemedicine:The integration of telehealth technologies for remote patient monitoring and consultation,facilitating timely interventions.Artificial intelligence(AI):AI-driven tools for early disease detection,predictive analytics,and treatment optimization,enhancing clinical decision-making.Organ Support:Advanced life support systems,such as Extracorporeal Membrane Oxygenation and Continuous Renal Replacement Therapy provide better organ support.Infection Control:Innovative infection control measures to combat emerging pathogens and reduce healthcare-associated infections.Ventilation Strategies:Precision ventilation modes and lung-protective strategies to minimize ventilatorinduced lung injury.Sepsis Management:Early recognition and aggressive management of sepsis with tailored interventions.Patient-Centered Care:A shift towards patient-centered care focusing on psychological and emotional wellbeing in addition to medical needs.We conducted a thorough literature search on PubMed,EMBASE,and Scopus using our tailored strategy,incorporating keywords such as critical care,telemedicine,and sepsis management.A total of 125 articles meeting our criteria were included for qualitative synthesis.To ensure reliability,we focused only on articles published in the English language within the last two decades,excluding animal studies,in vitro/molecular studies,and non-original data like editorials,letters,protocols,and conference abstracts.These advancements reflect a dynamic land

关键词： Critical care medicine Intensive care unit Precision medicine Telemedicine Artificial intelligence Organ support Sepsis Infection control Patient-centered care

Left bundle branch pacing vs biventricular pacing in heart failure patients with left bundle branch block:A systematic review and meta-analysis

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World Journal of Cardiology 2024年第1期16卷 40-48页

作者： Farah Yasmin Abdul Moeed Rohan Kumar Ochani Hamna Raheel Malik Ali Ehtsham Awan Ayesha Liaquat Arisha Saleem Muhammad Aamir Nael Hawwa salim Surani Department of Internal Medicine Yale University School of MedicineNew HavenCT 06511United States Department of Medicine Dow University of Health ScienceKarachi 74200SindhPakistan Department of Medicine SUNNY Upstate Medical UniversitySyracuseNY 13210United States Department of Cardiovascular Medicine Lehigh Valley Heart and Vascular InstituteAllentownPA 18105United States Department of Medicine Cleveland ClinicClevelandOH 44195United States Department of Medicine&Pharmacology Texas A&M UniversityCollege StationTX 77843United States

BACKGROUND Left bundle branch pacing(LBBP)is a novel pacing modality of cardiac resynchronization therapy(CRT)that achieves more physiologic native ventricular activation than biventricular pacing(BiVP).AIM To explore the validity of electromechanical resynchronization,clinical and echocardiographic response of LBBP-CRT.METHODS Systematic review and Meta-analysis were conducted in accordance with the standard guidelines as mentioned in detail in the methodology section.RESULTS In our analysis,the success rate of LBBP-CRT was determined to be 91.1%.LBBP CRT significantly shortened QRS duration,with significant improvement in echocardiographic parameters,including left ventricular ejection fraction,left ventricular end-diastolic diameter and left ventricular end-systolic diameter in comparison with BiVP-CRT.CONCLUSION A significant reduction in New York Heart Association class and B-type natriuretic peptide levels was also observed in the LBBP-CRT group vs BiVP-CRT group.Lastly,the LBBP-CRT cohort had a reduced pacing threshold at follow-up as compared to BiVP-CRT.

关键词： Left bundle branch pacing Biventricular pacing QRS duration Left ventricular ejection fraction Heart failure