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Outcomes in children with Clostridium difficile infection:results from a nationwide survey

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Gastroenterology Report 2016年第4期4卷 293-298,I0002页

作者： Arjun Gupta Darrell S Pardi Larry M Baddour Sahil Khanna divisions of Infectious Diseases Mayo ClinicRochesterMNUSA divisions of Gastroenterology and Hepatology Mayo ClinicRochesterMNUSA Department of Internal medicine University of Texas Southwestern Medical CenterDallasTXUSA

Objective:Hospital-and population-based studies demonstrate an increasing incidence of Clostridium difficile infection(CDI)in adults and children;although pediatric CDI outcomes are incompletely *** analysed United States National Hospital Discharge Survey(NHDS)data to study CDI in hospitalized ***:NHDS data for 2005–2009(demographics,diagnoses and discharge status)were obtained;cases and comorbidities were identified using ICD-9 *** univariate and multivariate analyses were performed to ascertain incidence of CDI;associations between CDI and outcomes[length of stay(LOS),colectomy,all-cause in-hospital mortality and discharge to a care facility(DTCF)].Results:Of an estimated 13.8 million pediatric inpatients;46176 had CDI;median age was 3 years;overall incidence was 33.5/10000 *** annual frequency of CDI did not vary from 2005 to 2009(0.24–0.43%;P=0.64).On univariate analyses,children with CDI had a longer median LOS(6 vs 2 days),higher rates of colectomy[odds ratio(OR)2.0;95%confidence interval(CI)1.7–2.4],mortality(OR 2.5;95% CI 2.3–2.7),and DTCF(OR 1.6;95% CI 1.6–1.7)(all P<0.0001).After adjusting for age,sex and comorbidities,CDI was an independent and the strongest predictor of increased LOS(adjusted mean difference,6.4 days;95% CI 5.4–7.4),higher rates of colectomy(OR 2.1;95% CI 1.8–2.5),mortality(OR 2.3;95% CI 2.2–2.5),and DTCF(OR 1.7;95% CI 1.6–1.8)(all P<0.0001).On excluding infants from the analysis,children with CDI had higher rates of mortality,DTCF and longer LOS than children without ***:Despite increased awareness and advancements in management,CDI remains a significant problem and is associated with increased LOS,colectomy,in-hospital mortality and DTCF in hospitalized children.

关键词： Clostridium difficile infection children pediatric outcomes epidemiology

Retrograde jejunoduodenogastric intussusception due to a replacement percutaneous gastrostomy tube presenting as upper gastrointestinal bleeding

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World Journal of Gastroenterology 2007年第39期13卷 5282-5284页

作者： Eric Ibegbu Manish Relan Kenneth J Vega divisions of Gastroenterology and General Internal medicine University of Florida Health Science Center/Jacksonville Jacksonville FL32207 United States

Percutaneous endoscopic gastrostomy (PEG) tube complications can be serious or life threatening. Retrograde intussusception is a very rare complication of PEG tubes with only 9 cases reported in the literature. We describe a case of retrograde intussusception, associated with the use of a Foley catheter as a replacement gastrostomy tube, presenting with upper gastrointestinal bleeding. To our knowledge, this is the first reported case of PEG-related retrograde intussusception successfully managed in a non-surgical manner. Retrograde intussusception likely occurred due to migration of the replacement tube with resultant securing and invagination of the proximal jejunum when the gastrostomy tube was anchored to the abdominal wall.

关键词： Percutaneous endoscopic gastrostomy Intussusception Migration and upper gastrointestinal bleeding

Hepatotoxicity Secondary to Chemotherapy

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Journal of Clinical and Translational Hepatology 2014年第2期2卷 95-102页

作者： Alla Grigorian Christopher B. O'Brien divisions of Liver and GI Transplantation University of Miami School of Medicine Miami FL USA

The difficult problem faced by multiple generation of practi-cing physicians is determining the cause of abnormal liver function tests in cancer patients on chemotherapy. Hepatotoxicity from chemotherapy occurs frequently from an unpredictable or idiosyncratic reaction. Despite remark-able advances in our understanding of the mechanisms of action, pharmacodynamics, and interrelationships between the liver and chemotherapy, the underlying etiology of hepatic toxicity for various agents remains unexplained. Here, we present a concise review of the broad differential diagnosis for abnormal liver function tests (LFTs) in oncology patients.

关键词： Hepatotoxicity Drugs Cancer Chemotherapy Liver

Acute heart failure in the elderly:setting related differences in clinical features and management

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Journal of Geriatric Cardiology 2021年第6期18卷 407-415页

作者： Francesco Orso Alessandra Pratesi Andrea Herbst Anna Chiara Baroncini Francesca Bacci Gabriele Ciuti Andrea Berni Camilla Tozzetti Carlo Nozzoli Alberto Moggi Pignone Loredana Poggesi Luciano Gabbani Mauro Di Bari Francesco Fattirolli Massimo Milli Andrea Ungar NiccolòMarchionni Samuele Baldasseroni Heart Failure Clinic Division of Geriatric Medicine and Intensive Care UnitAzienda Ospedaliero-Universitaria CareggiFlorenceItaly Department of Experimental and Clinical medicine University of FlorenceFlorenceItaly divisions of Internal medicine 1 Azienda Ospedaliero-Universitaria CareggiFlorenceItaly divisions of Internal medicine 4 Azienda Ospedaliero-Universitaria CareggiFlorenceItaly divisions of Internal medicine 3 Azienda Ospedaliero-Universitaria CareggiFlorenceItaly Division of Medical-Geriatric Department Azienda Ospedaliero-Universitaria CareggiFlorenceItaly Department of Cardiothoracovascular medicine Azienda Ospedaliero-Universitaria CareggiFlorenceItaly Division of Cardiology Santa Maria Nuova HospitalFlorenceItaly

BACKGROUND Administrative data show that acute heart failure(HF)patients are older than those enrolled in clinical registries and frequently admitted to non-cardiological settings of *** purpose of this study was to describe clinical characteristics of old patients hospitalised for acute HF in Cardiology,Internal medicine or Geriatrics *** Data came from ATHENA(AcuTe Heart failurE in advaNced Age)registry which included elderly patients(≥65 years)admitted to the above mentioned settings of care from December 1,2014 to December 1,*** We enrolled 396 patients,15.4%assigned to Cardiology,69.7%to Internal medicine,and 14.9%to a Geriatrics *** age was 83.5±7.6 years(51.8%of patients≥85 years)and was higher in patients admitted to Geriatrics(Pmedicine(8±5.2 days),Pmedicine(5.8%),P=*** In elderly patients hospitalised for acute HF,clinical characteristics and management differ significantly according to the setting of admission.

关键词： admitted clinical acute

VISUALIZATION OF DYNAMIC ORGANIZATION OF CYTOSKELETON GELS IN LIVING CELLS BY HYBRID-SPM

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Chinese Journal of Polymer Science 2003年第2期21卷 169-174页

作者： K.Kawabata Y.Sado M.Nagayama T.Nitta K.Nemoto Y.Koyama H.Haga divisions of Biological Sciences Graduate School of Science Hokkaido University 060-0810 SapporoDivisions of Physics Graduate School of Science. Hokkaido University 060-0810 SapporoDivisions of Physics Graduate School of Science. Hokkaido University 060-0810 SapporoDivisions of Physics Graduate School of Science. Hokkaido University 060-0810 SapporoDivisions of Physics Graduate School of Science. Hokkaido University 060-0810 SapporoDepartment of Biochemistry Hokkaido University Graduate School of Medicine Sapporo 060-8638 JapanDivisions of Physics Graduate School of Science Hokkaido University 060-0810 Sapporo

We succeeded in performing of hybrid Scanning Probe Microscopy (hybrid-SPM) in which mechanical-SPM andfluorescence microscopy are combined. This technique is able to measure simultaneously mechanical properties anddistribution of cytoskeletons of living cells by using green fluorescent protein. We measured evolution of both local elasticityand distributions of actin stress fibers in an identical fibroblast living in physiological conditions. The SPM experimentsrevealed that stiffer lines develop in living cells, which correspond to actin stress fibers. The elasticity of the actin stressfibers is as high as 100 kPa. We discuss mechanical effects on the development of actin filament networks.

关键词： Scanning probe microscopy Green fluorescent protein Fibroblast Cell migration, Cytoskeleton Elasticity

Surgical resection of a solitary para-aortic lymph node metastasis from hepatocellular carcinoma

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World Journal of Gastroenterology 2012年第23期18卷 3027-3031页

作者： Junji Ueda Hiroshi Yoshida Yasuhiro Mamada Nobuhiko Taniai Sho Mineta Masato Yoshioka Youichi Kawano Tetsuya Shimizu Etsuko Hara Chiaki Kawamoto Keiko Kaneko Eiji Uchida Department of Surgery Nippon Medical School Tokyo 113-8603 Japan divisions of Cardiology Hepatology Geriatrics and Integrated Medicine Department of Internal Medicine Nippon Medical School Tokyo 113-8603 Japan

Lymph node (LN) metastases from hepatocellular carcinoma (HCC) are considered uncommon. We describe the surgical resection of a solitary para-aortic LN metastasis from HCC. A 65-year-old Japanese man with B-type liver cirrhosis was admitted for the evaluation of a liver tumor. He had already undergone radiofrequency ablation, transcatheter arterial chemoembolization, and percutaneous ethanol injection therapy for HCC. Despite treatment, viable regions remained in segments 4 and 8. We performed a right paramedian sectionectomy with partial resection of the left paramedian section of the liver. Six months later, serum concentrations of alpha-fetoprotein (189 ng/mL) and PIVKA-2 (507 mAU/mL) increased. Enhanced com- puted tomography of the abdomen revealed a tumor (20 mm in diameter) on the right side of the abdominal aorta. Fluorine-18 fluorodeoxyglucose positron emission tomography revealed an increased standard uptake value. There was no evidence of recurrence in other regions. Esophagogastroduodenoscopy and colonoscopy revealed no malignant tumor in the gastrointestinal tract. Para-aortic LN metastasis from HCC was thus diagnosed. We performed lymphadenectomy. Histopathological examination revealed that the tumor was largely necrotic, with poorly differentiated HCC on its surface, which confirmed the suspected diagnosis. After 6 mo tumor marker levels were normal, with no evidence of recurrence. Our experience suggests that a solitary para-aortic LN metastasis from HCC can be treated surgically.

关键词： Surgical resection Lymph node metasta-sis Hepatocellular carcinoma Hepatectomy Positronemission tomography

Single-cell RNA sequencing identifies novel cell types in Drosophila blood

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Journal of Genetics and Genomics 2020年第4期47卷 175-186页

作者： Yulong Fu Xiaohu Huang Peng Zhang Joyce van de Leemput Zhe Han Center for Precision Disease Modeling Department of MedicineUniversity of Maryland School of MedicineBaltimoreMD21201USA divisions of Immunotherapy University of Maryland School of MedicineBaltimoreMD21201USA Division of Endocrinology Diabetes and NutritionDepartment of MedicineUniversity of Maryland School of MedicineBaltimoreMD21201USA

Drosophila has been extensively used to model the human blood-immune system,as both systems share many developmental and immune response ***,while many human blood cell types have been identified,only three were found in flies:plasmatocytes,crystal cells and *** better understand the complexity of fly blood system,we used single-cell RNA sequencing technology to generate co mprehensive gene expression profiles for Drosophila circulating blood *** addition to the known cell types,we identified two new Drosophila blood cell types:thanacytes and ***,which express many stimulus response genes,are involved in distinct responses to different types of ***,which express cell fate commitment and signaling genes,appear to be involved in keeping stem cells in the circulating ***,our data revealed four novel plasmatocyte subtypes(Ppn+,CAH7^+,Lsp^+and reservoir plasmatocytes),each with unique molecular identities and distinct predicted *** also identified cross-species markers from Drosophila hemocytes to human blood *** analysis unveiled a more complex Drosophila blood system and broadened the scope of using Drosophila to model human blood system in development and disease.

关键词： Drosophila Blood Single-cell RNA-seq Thanacyte Primocyte Plasmatocyte

The next generation of cancer management

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Cancer Biology & medicine 2016年第1期13卷 1-2页

作者： Wayne W.Grody divisions of Medical Genetics and Molecular Diagnostics Departments of Pathology & Laboratory Medicine Pediatrics and Human Genetics UCLA School of Medicine UCLA Institute for Society and Genetics Molecular Diagnostic Laboratories and Clinical Genomics Center UCLA Medical Center

As readers of Cancer Biology and medicine well know,there has been a seismic shift in human molecular biology over the past few years,as momentous in its own way as the discovery of the double-helical structure of DNA by Watson and Crick 60 years ago,the elucidation of the genetic code shortly thereafter,the advent of recombinant DNA and gene cloningin the 1970s, and the introduction of the polymerase chain reaction in the mid-1980s.

关键词： Next-generation sequencing tumor sequencing targeted sequencing incidental findings variants of uncertain significance

Medical treatment of peripheral arterial disease in the elderly

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Journal of Geriatric Cardiology 2007年第2期4卷 93-100页

作者： Wilbert S. Aronow Department of medicine Divisions of Cardiology Geriatrics and Pulmonary/Critical Care Medicine New York Medical College Valhalla NY USA

Smoking should be stopped and hypertension, diabetes mellitus, dyslipidemia, and hypothyroidism be treated in elderly patients with peripheral arterial disease (PAD). Statins reduce the incidence of intermittent claudication and improve exercise duration until the onset of intermittent claudication in persons with PAD and hypercholesterolemia. Antiplatelet drugs such as aspirin or clopidogrel, especially clopidogrel, angiotensin-converting enzyme inhibitors, and statins should be given to all persons with PAD. Beta blockers should be given if coronary artery disease is present. Exercise rehabilitation programs and cilostazol lengthen exercise time until intermittent claudication develops. Chelation therapy should be avoided.

关键词： peripheral arterial disease intermittent claudication cilostazol antiplatelet drugs statins angiotensin-converting enzyme inhibitors beta-blockers exercise rehabilitation