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Deferred revascularization in diabetic patient according to combined invasive functional and intravascular imaging data:A case report

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World Journal of Clinical Cases 2024年第13期12卷 2269-2274页

作者： Arif Al Nooryani Wael Aboushokka Branko Beleslin Biljana Nedeljkovic-Beleslin Department of Cardiology Al Qassimi HospitalSharjah 1234United Arab Emirates Department of Cardiology Medical FacultyUniversity of BelgradeBelgrade 11000Serbia Institute of Endocrinology Diabetes and Metabolic DisordersUniveristy Clinical Center of SerbiaBelgrade 11000Serbia Department of internal medicine/Endocrinology Medical facultyUniversity of BelgradeBelgrade 11000Serbia

BACKGROUND Invasive functional evaluation by fractional flow reserve(FFR)is considered as a gold standard for the evaluation of intermediate coronary ***,in patients with diabetes due to accelerated progression of atherosclerosis the outcome may be worse even in the presence of negative functional *** SUMMARY We present a case of 55-year-old male diabetic patient who was admitted for chest *** coronary angiography disclosed 2 intermediate stenoses of the obtuse marginal branch with no evidence of restenosis on previously implanted *** undergone invasive functional testing of intermediate lesion with preserved FFR(0.88),low coronary flow reserve(1.2)and very high index of microvascular resistance(84).Due to discrepancy in invasive functional parameters,intravascular imaging with optical coherence tomography showed fibrotic stenoses without signs of thin-sup *** of the preserved FFR and no signs of vulnerable plaque,the interventional procedure was deferred and the patient continued with optimal *** Combined functional and anatomic imaging of intermediate coronary stenosis in diabetic patients represent comprehensive contemporary decision pathway in the management of the patients.

关键词： Fractional flow reserve Coronary flow reserve Index of microvascular resistance Optical coherence tomography Intermediate coronary stenosis Case report

Recurrent stroke admissions with vs without COVID-19 and associated in-hospital mortality: A United States nationwide analysis, 2020

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World Journal of Virology 2024年第3期13卷 98-106页

作者： Rupak Desai Sai Priyanka Mellacheruvu Sai Anusha Akella Adil Sarvar Mohammed Mushfequa Hussain Abdul Aziz Mohammed Pakhal Saketha Praveena Sunkara Jyotsna Gummadi Paritharsh Ghantasala Outcomes Research Independent ResearcherAtlantaGA 30033United States Department of Public Health University of MassachusettsLowellMA 01854United States Department of internal medicine One Brooklyn Health-Interfaith Medical CenterBrooklynNY 11213United States Department of internal medicine Central Michigan University College of MedicineSaginawMI 48602United States Department of internal medicine Kamineni Institute of Medical SciencesNarketpally 508254India Department of internal medicine Bhaskar Medical CollegeMoinabad 500075HyderabadIndia Department of internal medicine MedStar Medical GroupCharlotte HallMD 20622United States Department of medicine Medstar Franklin Square Medical CenterBaltimoreMD 21237United States

BACKGROUND Coronavirus disease 2019(COVID-19)has been shown to increase the risk of ***,the prevalence and risk of recurrent stroke in COVID-19 patients with prior stroke/transient ischemic attack(TIA),as well as its impact on mor-tality,are not *** To evaluate the impact of COVID-19 on in-hospital mortality,length of stay,and healthcare costs in patients with recurrent *** We identified admissions of recurrent stroke(current acute ischemic stroke admissions with at least one prior TIA or stroke)in patients with and without COVID-19 using ICD-10-CM codes using the National Inpatient Sample(2020).We analyzed the impact of COVID-19 on mortality following recurrent stroke admissions by *** Of 97455 admissions with recurrent stroke,2140(2.2%)belonged to the COVID-19-positive *** COVID-19-positive group had a higher prevalence of diabetes and chronic kidney disease vs the COVID-19 negative group(P65 years,patients aged 45–64 years,Asians,Hispanics,whites,and blacks in the COVID-19 positive group had higher rates of all-cause mortality than the COVID-19 negative group(P65(OR:7.04,95%CI:5.24-9.44),males(OR:7.82,95%CI:5.38-11.35)compared to females(OR:6.15,95%CI:4.12-9.18),and in Hispanics(OR:15.47,95%CI:7.61-31.44)and Asians/Pacific Islanders(OR:14.93,95%CI:7.22-30.87)compared to blacks(OR:5.73,95%CI:3.08-10.68),and whites(OR:5.54,95%CI:3.79-8.09).CONCLUSION The study highlights the increased risk of all-cause in-hospital mortality in recurrent stroke patients with COVID-19,with a more pronounced increase in middle-aged patients,males,Hispanics,or Asians.

关键词： COVID-19 SARS-CoV-2 Recurrent stroke Mortality Hospitalization Comorbidities Acute ischemic stroke

Point-of-care ultrasonography spotlight:Could venous excess ultrasound serve as a shared language for internists and intensivists?

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World Journal of Critical Care medicine 2024年第2期13卷 126-136页

作者： Anosh Aslam Khan Hasham Saeed Ibtehaj Ul Haque Ayman Iqbal Doantrang Du Abhilash Koratala Department of internal medicine Monmouth Medical CenterLong BranchNJ 07740United States Department of internal medicine Trinitas Regional Medical CenterElizabethNJ 07202United States Department of Anesthesiology Dr.Ruth K M Pfau Civil HospitalKarachi 74400Pakistan Department of internal medicine Dow Medical CollegeKarachi 74200Pakistan Division of Nephrology Medical College of WisconsinMilwaukeeWI 53226United States

Point-of-care ultrasonography(POCUS),particularly venous excess ultrasound(VExUS)is emerging as a valuable bedside tool to gain real-time hemodynamic *** modality,derived from hepatic vein,portal vein,and intrarenal vessel Doppler patterns,offers a scoring system for dynamic venous congestion *** an assessment can be crucial in effective management of patients with heart failure *** facilitates diagnosis,quantification of congestion,prognostication,and monitoring the efficacy of decongestive *** such,it can effectively help to manage cardiorenal syndromes in various clinical *** or eVExUS explores additional veins,potentially broadening its *** VExUS demonstrates promising outcomes,challenges persist,particularly in cases involving renal and liver parenchymal disease,arrhythmias,and situations of pressure and volume overload *** in utilizing spectral Doppler is pivotal for clinicians to effectively employ this ***,the integration of POCUS,especially advanced applications like VExUS,into routine clinical practice necessitates enhanced training across medical specialties.

关键词： Point-of-care ultrasonography Ultrasound Venous excess ultrasound Doppler Congestion Heart failure

Calcium/calcimimetic via calcium-sensing receptor ameliorates cholera toxin-induced secretory diarrhea in mice

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World Journal of Gastroenterology 2024年第3期30卷 268-279页

作者： Lie-Qi Tang Johnathan Fraebel Shi Jin Steven P Winesett Jane Harrell Wen-Han Chang Sam Xianjun Cheng Department of Pediatrics University of FloridaGainesvilleFL 32610United States College of medicine University of FloridaGainesvilleFL 32610United States Applied Physiology and Kinesiology University of FloridaGainesvilleFL 32610United States Brain Rehabilitation Research center Malcom Randall VA Medical CenterGainesvilleFL 32610United States Department of medicine Endocrine Research UnitVeterans Affairs Medical CenterUniversity of CaliforniaSan FranciscoSan FranciscoCA 94121United States Department of Pediatric Gastroenterology Hepatologyand NutritionUniversity of Florida Shands Children’s HospitalGainesvilleFL 32608United States

BACKGROUND Enterotoxins produce diarrhea through direct epithelial action and indirectly by activating the enteric nervous ***-sensing receptor(CaSR)inhibits both *** latter has been well documented in vitro but not in *** hypothesis to be tested was that activating CaSR inhibits diarrhea in *** To determine whether CaSR agonists ameliorate secretory diarrhea evoked by cholera toxin(CTX)in *** CTX was given orally to C57BL/6 mice to induce *** and calci-mimetic R568 were used to activate *** maximize their local intestinal actions,calcium was administered luminally via oral rehydration solution(ORS),whereas R568 was applied serosally using an intraperitoneal *** verify that their actions resulted from the intestine,effects were also examined on Cre-lox intestine-specific CaSR *** outcome was measured biochemically by monitoring changes in fecal Cl-or clinically by assessing stool consistency and weight *** CTX induced secretory diarrhea,as evidenced by increases in fecal Cl-,stool consistency,and weight loss following CTX exposure,but did not alter CaSR,neither in content nor in ***,calcium and R568 were each able to ameliorate diarrhea when applied to diseased *** CaSR involvement is suggested by gene knockout experiments where the anti-diarrheal actions of R568 were lost in intestinal epithelial CaSR knockouts(villinCre/Casrflox/flox)and neuronal CaSR knockouts(nestinCre/Casrflox/flox).CONCLUSION Treatment of acute secretory diarrheas remains a global *** advances in diarrhea research,few have been made in the realm of diarrhea *** therapy has remained the standard of care,although it does not halt the losses of intestinal fluid and ions caused by *** is no cost-effective therapeutic for *** and other studies suggest that adding calcium to ORS or using calcimimetics to activate intestinal CaSR might

关键词： Cholera Enteric nervous system Secretory diarrhea Oral rehydration solution Calcium-sensing receptor Gene knockout

The Role of Adipose Tissue-derived Exosomes in Chronic Metabolic Disorders

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Current medical Science 2024年第3期44卷 463-474页

作者： Rui HE Yong CHEN Division of Endocrinology Department of Internal MedicineTongji HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan430030China Laboratory of Endocrinology & Metabolism Key Laboratory of Vascular Aging of the Ministry of EducationTongji HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan430030China Branch of National Clinical Research center for Metabolic Diseases Wuhan430030China

Excessive fat deposition in obese subjects promotes the occurrence of metabolic diseases,such as type 2 diabetes mellitus(T2DM),cardiovascular diseases,and non-alcoholic fatty liver disease(NAFLD).Adipose tissue is not only the main form of energy storage but also an endocrine organ that not only secretes adipocytokines but also releases many extracellular vesicles(EVs)that play a role in the regulation of whole-body *** are a subtype of EVs,and accumulating evidence indicates that adipose tissue exosomes(AT Exos)mediate crosstalk between adipose tissue and multiple organs by being transferred to targeted cells or tissues through paracrine or endocrine ***,the roles of AT Exos in crosstalk with metabolic organs remain to be fully *** this review,we summarize the latest research progress on the role of AT Exos in the regulation of metabolic ***,we discuss the potential role of AT Exos as biomarkers in metabolic diseases and their clinical application.

关键词： exosome adipose tissue obesity diabetes chronic metabolic disorder miRNA

Development of donor specific antibodies after SARS-CoV-2 vaccination:What do we know so far?

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World Journal of Meta-Analysis 2024年第2期12卷 1-4页

作者： Ahmed Daoud Karim Soliman Maria Aurora Posadas Salas Sakshi vaishnav Genta Uehara AhmedAbdelkader Tibor Fulop Michael J Casey Department of medicine Division of NephrologyMedical University of South CarolinaCharlestonSC 29425United States Department of medicine Cairo University Medical SchoolCairo 11211Egypt Department of medicine Medical ServicesRalph H.Johnson VA Medical CenterCharlestonSC 29425United States Department of medicine Division of NephrologyMedical ServicesRalph H.Johnson VA Medical CenterCharlestonSC 29425United States

vaccination against Coronavirus disease-19(COVID-19)was pivotal to limit spread,morbidity and *** aim is to find out whether vaccines against COVID-19 lead to an immunological response stimulating the production of de novo donor specific antibodies(DSAs)or increase in mean fluorescence intensity(MFI)of pre-existing DSAs in kidney transplant recipients(KTRs).This study involved a detailed literature search through December 2nd,2023 using PubMed as the primary *** search strategy incorporated a combination of relevant medical Subject Headings terms and keywords:"COVID-19","SARS-CoV-2 vaccination","Kidney,Renal Transplant",and"Donor specific antibodies".The results from related studies were collated and analyzed.A total of 6 studies were identified,encompassing 460 KTRs vaccinated against *** responses were detected in 8 KTRs of which 5 had increased MFIs,1 had de novo DSA,and 2 were categorized as either having de novo DSA or increased *** were 48 KTRs with pre-existing DSAs prior to vaccination,but one study(Massa et al)did not report whether pre-existing DSAs were associated with post vaccination *** the remaining 5 studies,35 KTRs with pre-existing DSAs were identified of which 7 KTRs(20%)developed de novo DSAs or increased ***,no immunological response was detected in 452(98.3%)*** study affirms prior reports that COVID-19 vaccination is safe for KTRs,especially if there are no pre-existing ***,if KTRs have pre-existing DSAs,then an increased immunological risk may be *** findings need to be taken cautiously as they are based on a limited number of patients so further studies are still needed for confirmation.

关键词： COVID-19 SARS-CoV-2 vaccination Kidney Renal transplant Donor specific antibodies

Efficacy and safety of utidelone for the treatment of patients with locally advanced or metastatic non-small-cell lung cancer who have failed standard second-line treatment:A phase 2 clinical trial(BG01-1801)

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Cancer Pathogenesis and Therapy 2024年第2期2卷 103-111页

作者： Yuankai Shi Gongyan Chen Yanqiu Zhao Jing Zhao Lin Lin Department of medical Oncology National Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Sciences&Peking Union Medical CollegeBeijing Key Laboratory of Clinical Study On Anticancer Molecular Targeted DrugsBeijing 100021China Department of Respiration Harbin Medical University Cancer HospitalHarbinHeilongjiang 150040China Respiratory Department of internal medicine Henan Provincial Cancer HospitalZhengzhouHenan 450003China Department of Pulmonary and Critcal Care medicine Peking Union Medical College HospitaChinese Academy of Medical Sciences&Peking Union Medical College Beijing100021China

Background:Chemotherapy remains the standard-of-care for many patients with locally advanced or metastatic non-small-cell lung cancer(NSCLC),but acquired resistance presents *** aim of this open-label,multicenter phase 2 clinical trial was to determine the efficacy and safety of utidelone,a novel genetically engineered epothilone analog and microtubule-stabilizing agent,as a third-or later-line treatment for locally advanced ormetastatic ***:Patients who had failed standard second-line treatment(including platinum-containing chemotherapy or targeted therapy)received utidelone(40 mg/m?via intravenous injection daily,day 1-5)every 21 *** primary endpoint was the objective response rate(ORR).Secondary endpoints were the duration of response(DoR),progression-free survival(PFS),overall survival(OS),and ***:From March 12,2019 to January 18,2021,26 pretreated patients with locally advanced or metastatic NSCLC(100%of patients had received prior platinum and 65.4%patients had received prior taxane treatment)were enrolled(80.8%of patients had adenocarcinoma).At baseline,nine(34.6%)patients had received secondline treatment,10(38.5%)patients had received third-line treatment,and seven(26.9%)patients had received fourth-or later-line *** the data cut-off date of August 10,2021,the median follow-up was 7.49 months(range,1.4-26.7 months).The ORR was 15.4%(95%confidence interval[CI],4.4%-34.9%)in the intention-totreat(ITT)cohort(N=26)and 19.0%(95%CI,5.4%-41.9%)in the per-protocol(PP)cohort(N=21).The disease control rate was 69.2%(95%CI,48.2%-85.7%)and 81.0%(95%CI,58.1%-94.6%)in the ITT and PP cohorts,*** median DoR was 4.1 months(95%CI,3.1-5.1 months)in the ITT *** median PFS was 4.37 months(95%CI,2.50-5.29 months)in the ITT cohort and 4.37 months(95%CI,2.50-9.76 months)in the PP *** median OS was not reached,and the 12-month OS rate was 69%(95%CI,45.1%-84.1%).Grade 3/4 treatment-emergent adverse events occur

关键词： Utidelone Locally advanced or metastatic non-small-cell lung cancer Efficacy Platinum-and taxane-refractory

Artemisia argyi extract subfraction exerts an antifungal effect against dermatophytes by disrupting mitochondrial morphology and function

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Chinese Journal of Natural medicines 2024年第1期22卷 47-61页

作者： CHEN Le ZHU Yunyun GUO Chaowei GUO Yujie ZHAO Lu MIAO Yuhuan DU Hongzhi LIU Dahui College of Pharmacy Hubei University of Chinese MedicineWuhan 430065China National Resource center for Chinese Materia Medica China Academy of Chinese Medical SciencesBeijing 100700China College of Pharmacy Nanjing University of Chinese MedicineNanjing 210023China

Artemisia argyi(***),a plant with a longstanding history as a raw material for traditional medicine and functional diets in Asia,has been used traditionally to bathe and soak feet for its disinfectant and itch-relieving *** its widespread use,scientific evidence validating the antifungal efficacy of *** water extract(AAWE)against dermatophytes,particularly Trichophyton rubrum,Trichophyton mentagrophytes,and Microsporum gypseum,remains *** study aimed to substantiate the scientific basis of the folkloric use of *** by evaluating the antifungal effects and the underlying molecular mechanisms of its active subfraction against *** results indicated that AAWE exhibited excellent antifungal effects against the three aforementioned dermatophyte *** subfraction AAWE6,isolated using D101 macroporous resin,emerged as the most potent *** minimum inhibitory concentrations(MICs)of AAWE6 against ***,***,and *** were 312.5,312.5,and 625μg·mL−1,*** electron microscopy(TEM)results and assays of enzymes linked to cell wall integrity and cell membrane function indicated that AAWE6 could penetrate the external protective barrier of ***,creating breaches(“small holes”),and disrupt the internal mitochondrial structure(“granary”).Furthermore,transcriptome data,quantitative real-time PCR(RT-qPCR),and biochemical assays corroborated the severe disruption of mitochondrial function,evidenced by inhibited tricarboxylic acid(TCA)cycle and energy ***,chemical characterization and molecular docking analyses identified flavonoids,primarily eupatilin(131.16±4.52 mg·g^(−1))and jaceosidin(4.17±0.18 mg·g^(−1)),as the active components of *** conclusion,the subfraction AAWE6 from *** exerts antifungal effects against dermatophytes by disrupting mitochondrial morphology and *** research validates the traditional use of *** and provides scient

关键词： Artemisia argyi Dermatophyte Antifungal activity Mitochondrial structure Mitochondrial function Transcriptome analysis

Young patient with a giant gastric bronchogenic cyst:A case report and review of literature

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World Journal of Clinical Cases 2024年第13期12卷 2254-2262页

作者： Xu-Ren Lu Xu-Guang Jiao Qi-Hang Sun Bo-Wen Li Qing-Shun Zhu Guang-Xu Zhu Jian-Jun Qu School of Clinical medicine Shandong Second Medical UniversityWeifang 261000Shandong ProvinceChina Department of Gastrointestinal Surgery medical center The First Affiliated HospitalShandong Second Medical UniversityWeifang 261000Shandong ProvinceChina

BACKGROUND Gastric bronchogenic cysts(BCs)are extremely rare cystic masses caused by abnormal development of the respiratory system during the embryonic *** bronchial cysts are rare lesions that were first reported in 1956;as of 2023,only 33 cases are available in the PubMed online *** usually have no clinical symptoms in the early stage,and imaging findings also lack ***,they are difficult to diagnose before histopathological *** SUMMARY A 34-year-old woman with respiratory distress presented at our *** ultrasound revealed an anechoic mass between the spleen,left kidney and gastric fundus,with hyperechogenic and soft elastography textures and with a size of approximately 6.5 cm×4.0 ***,a computed tomography scan demonstrated high density between the posterior stomach and the spleen and the left kidney,with uniform internal density and a small amount of *** maximum cross section was approximately 10.1 cm×6.1 cm,and the possibility of a cyst was *** the imaging findings did not suggest a malignancy and because the patient required complete resection,she underwent laparotomy ***,this cystic lesion was found to be located in the posterior wall of the large curvature of the fundus and was approximately 8 cm×6 cm in ***,the pathologists verified that the cyst in the fundus was a gastric *** patient recovered well,her symptoms of chest tightness disappeared,and the abdominal drain was removed on postoperative day 6,after which she was discharged on day 7 for 6 months of *** had no tumor recurrence or postoperative complications during the *** This is a valuable report as it describes an extremely rare case of gastric ***,this was a very young patient with a large BC in the stomach.

关键词： Bronchogenic cyst Stomach Endoscopic ultrasound-guided fine needle aspiration Endosonography Case report