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Sleep as a window to understand and regulate Alzheimer's disease:emerging roles of thalamic reticular nucleus

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Neural Regeneration Research 2025年第6期20卷 1711-1712页

作者： Haoqi Sun Shiqian Shen Robert J.Thomas M.Brandon Westover Can Zhang Department of Neurology Beth Israel Deaconess Medical CenterHarvard Medical SchoolBostonMAUSA Center for Translational Pain Research Department of AnesthesiaCritical Care and Pain MedicineMassachusetis General HospitalHarvard Medical SchoolBostonMAUSA division of Pulmonary Critical Care and Sleep MedicineDepartment of MedicineBeth Israel Deaconess Medical CenterHarvard Medical SchoolBostonMAUSA Genetics and Aging Research Unit McCance Center for Brain HealthMass General Institute for Neurodegenerative DiseaseDepartment of NeurologyMassachusetts General HospitalHarvard Medical SchoolBostonMAUSA

Introduction:Alzheimer 's disease(AD) is a common neurodegenerative disorder and the primary cause of dementia. Considerable evidence supports the “amyloid hypothesis,” stating that the pathogenesis of AD is primarily caused by the deposition of amyloid-β(Aβ), which drives tau phosphorylation, neuroinflammation, and neurodegeneration in the brain. The amyloid hypothesis is strengthened by the significant and moderate benefit of lecanemab, a humanized antibody through an anti-amyloid mechanism,showing slowed clinical decline(van Dyck et al.,2023). The recent positive results of anti-amyloid trials have brought back focus on the amyloid hypothesis through biochemical, genetic, and pharmacological approaches(Zhang, 2023).

关键词： Alzheimer inflammation hypothesis

Effects of diabetic ketoacidosis in the respiratory system

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World Journal of Diabetes 2019年第1期10卷 16-22页

作者： Alice Gallo de Moraes Salim Surani Department of Medicine Division of Pulmonary and Critical Care Medicine division of Pulmonary Critical Care and Sleep Medicine Texas A and M University

Diabetes affects approximately 30 million persons in the United States. Diabetes ketoacidosis is one of the most serious and acute complications of diabetes. At the time of presentation and during treatment of diabetic ketoacidosis(DKA), several metabolic and electrolyte derangements can ultimately result in respiratory compromise. Most commonly, hypokalemia, hypomagnesemia and hypophosphatemia can eventually lead to respiratory muscles ***, tachypnea, hyperpnea and more severely, Kussmaul breathing pattern can develop. Also, hydrostatic and non-hydrostatic pulmonary edema can occur secondary to volume shifts into the extracellular space and secondary to increased permeability of the pulmonary capillaries. The presence of respiratory failure in patients with DKA is associated with higher morbidity and mortality. Being familiar with the causes of respiratory compromise in DKA, and how to treat them, may represent better outcomes for patients with DKA.

关键词： Diabetes ketoacidosis Respiratory physiology Mechanical ventilation metabolic acidosis Hyperventilation Kussmaul breathing Respiratory failure

Current role of extracorporeal membrane oxygenation for the management of trauma patients:Indications and results

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World Journal of critical care Medicine 2025年第1期14卷 42-48页

作者： Mohammed Abdulrahman Maryam Makki Malak Bentaleb Dana Khamis Altamimi Marcelo AF Ribeiro Junior Department of Surgery College of Medicine and Health SciencesKhalifa UniversityAbu Dhabi 11001United Arab Emirates Department of Surgery Division of TraumaCritical Care and Acute Care SurgerySheikh Shakhbout Medical CityAbu Dhabi 11001United Arab Emirates Department of Surgery Sheikh Shakhbout Medical CityAbu Dhabi 91888ADUnited Arab Emirates Department of Surgery R Adams Cowley Shock Trauma CenterUniversity of MarylandBaltimoreMD 21201United States

Extracorporeal membrane oxygenation(ECMO)has emerged as a vital circulatory life support measure for patients with critical cardiac or pulmonary conditions unresponsive to conventional *** allows blood to be extracted from a patient and introduced to a machine that oxygenates blood and removes carbon *** blood is then reintroduced into the patient’s circulatory *** process makes ECMO essential for treating various medical conditions,both as a standalone therapy and as adjuvant ***-venous(VV)ECMO primarily supports respiratory function and indicates respiratory ***,veno-arterial(VA)ECMO provides hemodynamic and respiratory support and is suitable for cardiac-related *** study reviews recent literature to elucidate the evolving role of ECMO in trauma care,considering its procedural intricacies,indications,contraindications,and associated ***,the use of ECMO in trauma patients,particularly for acute respiratory distress syndrome and cardiogenic shock,has demonstrated promising outcomes despite challenges such as anticoagulation management and complications such as acute kidney injury,bleeding,thrombosis,and *** studies have shown that VV ECMO was associated with significantly higher survival rates than conventional mechanical ventilation,whereas other studies have reported that VA ECMO was associated with lower survival rates than VV *** plays a critical role in managing trauma patients,particularly those with acute respiratory *** research is necessary to explore the full potential of ECMO in trauma *** should have a clear understanding of the indications and contraindications for the use of ECMO to maximize its benefits in treating trauma patients.

关键词： Extracorporeal membrane oxygenation treatments Multiple trauma Respiratory distress syndrome Cardiogenic shock Contraindications Anticoagulants

Retropharyngeal abscess presenting as acute airway obstruction in a 66-year-old woman: A case report

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World Journal of Clinical Cases 2019年第22期7卷 3838-3843页

作者： Jian Lin Xiao-Mai Wu Jia-Xi Feng Mei-Fang Chen division of Pulmonary and critical care Medicine Wenzhou Medical University Affiliated Taizhou Hospital

BACKGROUND Adult retropharyngeal abscess(RPA)is extremely rare,and most cases reported in the literature were related to tuberculous *** present a case of RPA with acute airway obstruction as the main manifestation in a 66-year-old woman that was considered to be non-tubercular suppurative inflammation in the retropharyngeal *** SUMMARY A 66-year-old woman complaining of chills and fever was admitted to our *** was initially diagnosed with an acute upper respiratory tract *** lost consciousness twice during *** regained consciousness immediately upon emergency tracheal *** upper airway obstruction was suspected as arterial blood gas analysis showed obvious acute retention of carbon dioxide before the second tracheal *** diagnosis of RPA was confirmed by computed tomography and magnetic resonance *** kristinae was isolated from blood samples taken from both *** patient recovered and was subsequently discharged after receiving antibiotic therapy together with surgical incision and drainage of the *** Clinicians should be alert to the possibility of RPA in patients with acute airway *** incision and drainage is an effective treatment for RPA.

关键词： Retropharyngeal abscess Airway obstruction Kocuria kristinae Intubation Surgery Case report

Late immune consequences of combat trauma: A review of trauma-related immune dysfunction and potential therapies

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Military Medical Research 2019年第4期6卷 340-353页

作者： Kelly B.Thompson Luke T.Krispinsky Ryan J.Stark division of critical care Medicine Department of PediatricsVanderbilt University School of Medicine2200 Children’s WayNashvilleTN 37232USA division of Pediatric critical care Medicine Department of PediatricsUniformed Services UniversityNaval Medical Center PortsmouthPortsmouthVA 23708USA

With improvements in personnel and vehicular body armor,robust casualty evacuation capabilities,and damage control resuscitation strategies,more combat casualties are surviving to reach higher levels of care throughout the casualty evacuation *** such,medical centers are becoming more accustomed to managing the deleterious late consequences of combat trauma related to the dysregulation of the immune *** this review,we aim to highlight these late consequences and identify areas for future research and therapeutic *** leads to the dysregulation of both the innate and adaptive immune responses,which places the injured at risk for several late consequences,including delayed wound healing,late onset sepsis and infection,multi-organ dysfunction syndrome,and acute respiratory distress syndrome,which are significant for their association with the increased morbidity and mortality of wounded *** mechanisms by which these consequences develop are complex but include an imbalance of the immune system leading to robust inflammatory responses,triggered by the presence of damage associated molecules and other immune-modifying agents following *** strategies to improve outcomes have been difficult to develop as the immunophenotype of injured personnel following trauma is variable,fluid and difficult to *** more information regarding the triggers that lead to immune dysfunction following trauma is elucidated,it may be possible to identify the immunophenotype of injured personnel and provide targeted treatments to reduce the late consequences of trauma,which are known to lead to significant morbidity and mortality.

关键词： Trauma Sepsis Compensatory anti-inflammatory response syndrome Persistent inflammationimmunosuppression and catabolism syndrome Immune dysfunction

Inflammasome links traumatic brain injury, chronic traumatic encephalopathy, and Alzheimer's disease

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Neural Regeneration Research 2025年第6期20卷 1644-1664页

作者： Gabriela Seplovich Yazan Bouchi Juan Pablo de Rivero Vaccari Jennifer C.Munoz Pareja Andrew Reisner Laura Blackwell Yehia Mechref Kevin K.Wang J.Adrian Tyndall Binu Tharakan Firas Kobeissy Department of Surgery Morehouse School of MedicineAtlantaGAUSA Department of Neurobiology Center for NeurotraumaMultiomics&Biomarkers(CNMB)Neuroscience InstituteMorehouse School of MedicineAtlantaGAUSA Department of Neurological Surgery and the Miami Project to Cure Paralysis University of Miami Miller School of MedicineMiamiFLUSA division of Pediatric critical care Department of PediatricsUniversity of Miami Miller School of MedicineMiamiFLUSA Department of Pediatrics Emory UniversityAtlantaGAUSA Department of Neurosurgery Children’s Healthcare of AtlantaAtlantaGAUSA Department of Chemistry and Biochemistry Texas Tech UniversityLubbockTXUSA Morehouse School of Medicine AtlantaGAUSA

Traumatic brain injury, chronic traumatic encephalopathy, and Alzheimer's disease are three distinct neurological disorders that share common pathophysiological mechanisms involving neuroinflammation. One sequela of neuroinflammation includes the pathologic hyperphosphorylation of tau protein, an endogenous microtubule-associated protein that protects the integrity of neuronal cytoskeletons. Tau hyperphosphorylation results in protein misfolding and subsequent accumulation of tau tangles forming neurotoxic aggregates. These misfolded proteins are characteristic of traumatic brain injury, chronic traumatic encephalopathy, and Alzheimer's disease and can lead to downstream neuroinflammatory processes, including assembly and activation of the inflammasome complex. Inflammasomes refer to a family of multimeric protein units that, upon activation, release a cascade of signaling molecules resulting in caspase-induced cell death and inflammation mediated by the release of interleukin-1β cytokine. One specific inflammasome, the NOD-like receptor protein 3, has been proposed to be a key regulator of tau phosphorylation where it has been shown that prolonged NOD-like receptor protein 3 activation acts as a causal factor in pathological tau accumulation and spreading. This review begins by describing the epidemiology and pathophysiology of traumatic brain injury, chronic traumatic encephalopathy, and Alzheimer's disease. Next, we highlight neuroinflammation as an overriding theme and discuss the role of the NOD-like receptor protein 3 inflammasome in the formation of tau deposits and how such tauopathic entities spread throughout the brain. We then propose a novel framework linking traumatic brain injury, chronic traumatic encephalopathy, and Alzheimer's disease as inflammasomedependent pathologies that exist along a temporal continuum. Finally, we discuss potential therapeutic targets that may intercept this pathway and ultimately minimize long-term neurological decline.

关键词： Alzheimer's disease caspase-1 chronic traumatic encephalopathy inflammasomes neurodegeneration neuroinflammation NLRP1 NLRP3 pyroptosis tauopathy traumatic brain injury

Diffuse cystic lung diseases

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Frontiers of Medicine 2013年第3期7卷 316-327页

作者： Jay H.Ryu Xinlun Tian Misbah Baqir Kaifeng Xu division of Pulmonary and critical care Medicine Mayo ClinicRochesterMN 55905USA division of Respiratory Medicine Peking Union Medical College HospitalBeijing 100730China

Diffuse cystic lung diseases are uncommon but can present a diagnostic challenge because increasing number of diseases have been associated with this *** in the lung is defined as a round parenchymal lucency with a well-defined thin wall(<2 mm thickness).Focal or multifocal cystic lesions include blebs,bullae,pneumatoceles,congenital cystic lesions,traumatic lesions,and several infectious processes such as coccidioidomycosis,Pneumocystis jiroveci pneumonia,and hydatid disease.“Diffuse”distribution in the lung implies involvement of all *** lung involvement with cystic lesions can be seen in pulmonary lymphangioleiomyomatosis,pulmonary Langerhans’cell histiocytosis,lymphoid interstitial pneumonia,Birt-Hogg-Dubésyndrome,amyloidosis,light chain deposition disease,honeycomb lung associated with advanced fibrosis,and several other rare causes including metastatic ***-resolution computed tomography of the chest helps define morphologic features of the lung lesions as well as their distribution and associated features such as intrathoracic *** the tempo of the disease process and clinical context with chest imaging findings serve as important clues to defining the underlying nature of the cystic lung disease and guide diagnostic evaluation as well as management.

关键词： cyst lung disease interstitial lung disease lymphangioleiomyomatosis Langerhans’cell histiocytosis Birt-Hogg-Dubésyndrome

Boarding issue in a commercial flight for patients with cavitary pulmonary tuberculosis: A case report

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World Journal of Clinical Cases 2020年第3期8卷 546-551页

作者： Woori Jo Chuiyong Pak Yangjin Jegal Kwang Won Seo division of Pulmonary and critical care Medicine Department of Internal Medicine Ulsan University Hospital University of Ulsan College of Medicine

BACKGROUND Several studies have demonstrated that airborne transmission of Mycobacterium tuberculosis bacteria from patients with active pulmonary tuberculosis(TB) to other passengers or crew members can occur during long flights. As such, non-infectious TB patients are usually allowed to undertake air travel after taking the appropriate anti-TB drugs. However, the global guidelines for air travel for patients with TB are inconsistent and insufficiently detailed with respect to cavitary pulmonary TB(CPTB).CASE SUMMARY Here, we report a case in which a patient with multiple CPTB was permitted air travel, following negative sputum acid-fast bacilli smear tests after administration of proper anti-TB medication. The patient’s culture results were *** This case revealed that more specific guidelines regulating air travel for patients with CPTB are necessary.

关键词： Pulmonary tuberculosis Air travel Mycobacterium Case report

Glycemic targets in critically ill adults: A mini-review

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World Journal of Diabetes 2021年第10期12卷 1719-1730页

作者： Kay Choong See division of Respiratory and critical care Medicine Department of MedicineNational University HospitalSingapore 119228Singapore

Illness-induced hyperglycemia impairs neutrophil function,increases pro-inflammatory cytokines,inhibits fibrinolysis,and promotes cellular *** turn,these mechanisms lead to pneumonia and surgical site infections,prolonged mechanical ventilation,prolonged hospitalization,and increased *** optimal glucose control,blood glucose measurements need to be done accurately,frequently,and *** choosing glycemic targets,one should keep the glycemic variability<4 mmol/L and avoid targeting a lower limit of blood glucose<4.4 mmol/*** upper limit of blood glucose should be set according to casemix and the quality of glucose control.A lower glycemic target range(i.e.,blood glucose 4.5-7.8 mmol/L)would be favored for patients without diabetes mellitus,with traumatic brain injury,or who are at risk of surgical site *** avoid harm from hypoglycemia,strict adherence to glycemic control protocols and timely glucose measurements are *** contrast,a higher glycemic target range(i.e.,blood glucose 7.8-10 mmol/L)would be favored as a default choice for medical-surgical patients and patients with diabetes *** targets may be modified if technical advances for blood glucose measurement and control can be achieved.

关键词： Brain injuries Traumatic critical care Diabetes mellitus Glycemic control Insulin infusion systems Sepsis