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Liver Characterization of a Cohort of Alpha-1 Antitrypsin Deficiency Patients with and without Lung Disease

Journal of clinical and Translational Hepatology 2024年第10期12卷 845-856页

作者： Naweed Mohammad Regina Oshins Tongjun Gu Virginia Clark Jorge Lascano Naziheh Assarzadegan George Marek Mark Brantly Nazli Khodayari Division of Pulmonary Critical Care and Sleep MedicineCollege of MedicineUniversity of FloridaGainesvilleFLUSA Interdisciplinary Center for Biotechnology Research Bioinformatics CoreUniversity of FloridaGainesvilleFLUSA Division of Gastroenterology Hepatology and NutritionCollege of MedicineUniversity of FloridaGainesvilleFLUSA Division of Pathology Immunologyand Laboratory MedicineCollege of MedicineUniversity of FloridaGainesvilleFLUSA Division of Gastroenterology and Hepatology Mayo ClinicRochesterMNUSA

Background and Aims:Alpha-1 antitrypsin deficiency(AATD)is a genetic disorder characterized by the misfolding and accumulation of the mutant variant of alpha-1 antitrypsin(AAT)within hepatocytes,which limits its access to the circulation and exposes the lungs to protease-mediated tissue *** results in progressive liver disease secondary to AAT polymerization and accumulation,and chronic obstructive pulmonary disease(COPD)due to deficient levels of AAT within the *** goal was to characterize the unique effects of COPD secondary to AATD on liver disease and gene ***:A subcohort of AATD individuals with COPD(n=33)and AATD individuals without COPD(n=14)were evaluated in this study from our previously reported cross-sectional *** used immunohistochemistry to assess the AATD liver phenotype,and RNA sequencing to explore liver *** observed a distinct transcriptomic profile in liver tissues from AATD individuals with COPD compared to those ***:A total of 339 genes were differentially *** pathways related to fibrosis,extracellular matrix remodeling,collagen deposition,hepatocellular damage,and inflammation were significantly upregulated in the livers of AATD individuals with *** analysis also revealed higher levels of fibrosis and hepatocellular damage in these ***:Our data supports a relationship between the development of COPD and liver disease in AATD and introduces genes and pathways that may play a role in AATD liver disease when COPD is *** believe addressing lung impairment and airway inflammation may be an approach to managing AATD-related liver disease.

关键词： Alpha-1 antitrypsin deficiency Chronic obstructive pulmonary disease Liver fibrosis Liver biopsy Liver histology Transcriptomics

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Effects of Aromatherapy on Physical and Mental Health of Cancer Patients Undergoing Radiotherapy and/or Chemotherapy: A Meta-Analysis

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Chinese Journal of Integrative Medicine 2024年第5期30卷 449-457页

作者： XIE Shuang-ran MA Liang XU Xin-yu ZHOU Shu XIE Hui-miao XIE Chang-sheng The First clinical Medical College Zhejiang Chinese Medical UniversityHangzhou 310053China Department of Medical Oncology Hangzhou Traditional Chinese Medicine Hospital Affiliated to Zhejiang Chinese Medical UniversityHangzhou 310007China Department of Dermatology the Third Xiangya HospitalCentral South UniversityChangsha 410013China Department of Famous Chinese Medicine clinic the Second Affiliated Hospital of Zhejiang Chinese Medical UniversityHangzhou 310005China Department of Medical Oncology the First Affiliated Hospital of Zhejiang Chinese Medical UniversityHangzhou 310006China

Backgroup:Currently,aromatherapy is being increasingly utilized in clinical practice,particularly in managing the side effects associated with radiotherapy and ***,it remains to be established whether aromatherapy can effectively alleviate these ***:To investigate the effects of aromatherapy on the physical and mental health of patients with cancer undergoing radiotherapy and ***:Seven databases were researched from inception until September 29,2023,including PubMed,Scopus,and Web of Science,Chinese National Knowledge Infrastructure,Wanfang database,China Biology Medicine disc and VIP Chinese Medical Journal *** Manager version 5.3 was utilized for data *** Cochrane Risk of Bias tool RoB2 was employed to evaluate the quality of the literature included in the *** quality rating was assessed using the Grading of Recommendations Assessment,Development,and Evaluation(GRADE) approach through the GRADEpro GDT online ***:Nineteen studies involving 1,541 patients were *** can alleviate nausea [relative risk(RR)=0.64,95% confidence interval(CI):0.53 to 0.78,Psleep disorders [mean difference(MD)=-3.39,95% CI:-3.95 to-2.84,P<0.05,I^(2)=0%],relieve pain(SMD=-1.58,95% CI:-1.96 to-1.21,P<0.05,I^(2)=0%),mitigate fatigue(SMD=-1.28,95% CI:-2.44 to-0.11,P<0.05,I^(2)=93%) and enhance quality of life(SMD=0.50,95% CI:0.22 to 0.79,P<0.05,I^(2)=0%) in cancer patients after radiotherapy and chemotherapy,but it may not have a significant effect on *** risk of bias was high in the included studies using the Cochrane Risk of Bias tool RoB2,and no studies were considered to be of high grade according to the GRADE ***:Aromatherapy is an efficacious,safe a

关键词： aromatherapy cancer chemoradiotherapy physical psychological

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Spontaneous pneumothorax in a single lung transplant recipient-a blessing in disguise: A case report

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World Journal of clinical Cases 2020年第14期8卷 3031-3038页

作者： Himanshu Deshwal Subha Ghosh Kathleen Hogan Olufemi Akindipe Charles Randall Lane Atul C Mehta Division of Pulmonary Critical Care and Sleep MedicineNew York University Grossman School of MedicineNew YorkNY 10016United States Imaging Institute Section of Thoracic ImagingCleveland ClinicClevelandOH 44195United States Respiratory Institute Cleveland ClinicClevelandOH 44195United States

BACKGROUND End-stage chronic obstructive pulmonary disease(COPD)is one of the common lung diseases referred for lung *** to the international society of heart and lung transplantation,30%of all lung transplantations are carried out for COPD *** compared to bilateral lung transplant,singlelung transplant(SLT)has similar short-term and medium-term results for *** patients with severe upper lobe predominant emphysema,lung volume reduction surgery is an excellent alternative which results in improvement in functional status and long-term *** 2018,endobronchial valves were approved by the Food and Drug Administration for severe upper lobe predominant emphysema as they demonstrated improvement in lung function,exercise capacity,and quality of ***,the role of endobronchial valves in native lung emphysema in SLT patients has not been *** SUMMARY We describe an unusual case of severe emphysema who underwent a successful SLT 15 years ago and had gradual worsening of lung function suggestive of chronic lung allograft ***,her lung function improved significantly after a spontaneous pneumothorax of the native lung resulting in auto-deflation of large *** This case highlights the clinical significance of native lung hyperinflation in single lung transplant recipient and how spontaneous decompression due to pneumothorax led to clinical improvement in our patient.

关键词： Native lung hyperinflation Single lung transplant Pneumothorax Bronchoscopic lung volume reduction Endobronchial valve Case report

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Changes in sleep parameters following biomimetic oral appliance therapy: A case report

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World Journal of clinical Cases 2021年第10期9卷 2312-2319页

作者： G Dave Singh Shamshudin Kherani Institute of Craniofacial sleep Medicine Vivos TherapeuticsInc.Highlands RanchCO 80129United States Dental clinic Kherani Dental at AspenCalgary T3H0N6Canada

BACKGROUND Mandibular advancement devices(MADs)are used to treat mild to moderate obstructive sleep apnea(OSA),but there is a risk that the underlying condition can worsen in the ***,this case report is based on biomimetic oral appliance therapy as an alternative to MADs,which was found to be beneficial in the treatment of a case with severe *** SUMMARY An overnight sleep study was undertaken in a 50-year-old male with excessive daytime sleepiness that lead to a diagnosis of severe OSA as the apnea-hypopnea index(AHI)was found to be 32.8/*** the patient was unable to comply with continuous positive airway pressure therapy and declined surgical intervention,treatment with a MAD was *** 10 years later,another sleep study was performed with no MAD in the mouth,which revealed an AHI of 67.9/*** view of the deterioration in sleep quality,the patient sought alternative treatment and elected on biomimetic oral appliance therapy,using a mandibular repositioning nighttime appliance(mRNA appliance®,Vivos Therapeutics,Inc.,United States).After 10 mo,another sleep study was performed with no device in the patient’s mouth,which revealed an AHI of 11.8/h,a mean oxygen saturation of 94%and a mean oxygen desaturation index of 5.3%while *** analysis of the pre-and post-treatment study models of the upper jaw showed localized size increases of 15%-17%in the premolar regions and 15%-23%in the molar *** In adults with severe OSA that are unable to accept continuous positive airway pressure or surgical treatment,biomimetic oral appliance therapy may be preferable over MADs since biomimetic oral appliance therapy may be able to prevent worsening of sleep parameters by remodeling the nasomaxillary ***-term follow up studies are required to verify these novel findings.

关键词： Obstructive sleep apnea Biomimetic oral appliance therapy Continuous positive airway pressure Mandibular advancement device Case report

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Incorporation of integrative medicine education into undergraduate medical education:a longitudinal study

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Journal of Integrative Medicine 2017年第6期15卷 442-449页

作者： saswati mahapatra anjali bhagra bisrat fekadu zhuo li brent a.bauer dietlind l.wahner-roedler division of general internal medicine mayo clinicRochesterMinnesota 55905USA mayo clinic school of medicine mayo clinic college of medicine and scienceRochesterMinnesota 55905USA biostatistics unit mayo clinicJacksonvilleFlorida 32224USA

OBJECTIVE： Integrative medicine （IM） combines complementary medical approaches into conventional medicine and considers the whole person. We implemented a longitudinal IM short-course curriculum into our medical school education. This study aimed to evaluate the feasibility and effectiveness of the curriculum via knowledge and attitude surveys regarding IM among students. METHODS： A mandatory short IM curriculum across all years of medical school was created and taught by IM professionals and physician faculty members with expertise in integrative therapies. Graduating classes of 2015 and 2016 completed the same survey in their first and third years of medical school. Paired data analysis was done, and only students who completed surveys at both time points were included in final analyses. RESULTS： Of 52 students in each class, 17 （33%） in the class of 2015 and 22 （42%） in the class of 2016 completed both surveys. After the IM curriculum, students＇ knowledge of and comfort with several IM therapies--biofeedback, mindfulness, and the use of St. John＇s wort--improved significantly. Students＇ personal health practices also improved, including better sleep, exercise, and stress management for the class of 2015. Students graduating in 2016 reported decreased alcohol use in their third year compared with their first year. CONCLUSION： It is feasible to incorporate IM education into undergraduate medical education, and this is associated with improvement in students＇ knowledge of IM and personal health practices.

关键词： course curriculum education integrative medicine medical students

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Near-infrared spectroscopy(NIRS)as a useful tool to evaluate the treatment efficacy of positive airways pressure therapy in patients with obstructive sleep apnea syndrome(OSAS):A pilot study

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Journal of Innovative Optical Health Sciences 2014年第2期7卷 143-152页

作者： Zhongxing Zhang Maja Schneider Ursula Fritschi Lsabela Lehner Ramin Khatami sleep Center Clinic BarmelweidSwitzerland Department of Neurology Uniuersity Hospital Zurich University of ZurichSuitzerland

In obstructive sleep apnea syndrome(OSA)the periodic reduction or cessation of breathing dueto narrowing or occlusion of the upper airway during slep leads to an impaired cerebral vascularautoregulation that is associated with an increased cardiovascular risk,including ***-tinuous positive airways pressure(CPAP)therapy at night is the most effective treatment forOSA and has been shown to reduce the cardiovascular risk in OSA ***,there is nosuitable bedside monitoring method evaluating the recovery of cerebral hemodynamics duringCPAP ***-infrared spectroscopy(NiRS)is idelly suited for non-invasive monitoringthe cerebral hemodynamics during sleep due to its properties of local measurement,totally sa feapplication and good tolerance to *** this pilot study,we monitored cerebral hemody-namics during standard CPAP therapy at night in thre patients with severe OSA using *** found periodic oscllations in HbO2,HHb,tisue oxygenation index(TO1)and blood volume(BV)associa ted with periodic apnea events without CPAP in all OSA *** osillationswere eliminated under the optimal CPAP pressures in all *** results sugg ested thatthe recovery of cerebral hemodynamics impaired by apnea events can be evaluated by bedsideNIRS measurements in real time during ll night CPAP *** is a usefi bedsidemonitoring tool to evaluate the treatment elicacy of CPAP therapy in patients with OSA.

关键词： sleep cerebral hemodynamics hemodynamic oscillations bedside monitoring.

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Nasal Valve Surgery: How I do it?

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International Journal of Otolaryngology and Head & Neck Surgery 2013年第1期2卷 1-4页

作者： Abdul Rahman Al Ghareeb Jitendra Nagarbhai Patel Mostafa Bakry Ear Nose & Throat Sleep Well Clinic Noor Specialist Hospital Manama Bahrain

One of the reasons for patients attending ENT clinic with a persistent feeling of Nasal obstruction is the presence of a narrow nasal valve. Currently, there are many surgical methods for widening narrow nasal valves. Yet, most of these methods are difficult to perform and with unpredictable results. The main purpose of this study is to describe and evalu- ate our technique of minimally invasive nasal valve surgery. Thirty three patients, who attended our clinic complaining from of nasal obstruction, were evaluated for indication for nasal valve surgery, complications, and postoperative re- sults. Thirty one out of the 33 patients (94%) who underwent the surgery reported subjective improvement. Visual ana- logue score (VAS score) was used to estimate the degree of pre and postoperative nasal obstruction, the mean preopera- tive score was 8.891 and the mean postoperative was 3.241 and the improvement was statistically significant (P = 3.174). In conclusion, it can be said that the technique of Minimal Invasive Nasal Valve Surgery was found to be safe and extremely effective for most patients having narrow nasal valve.

关键词： Nasal Obstruction Nasal Valve Narrowing Nasal Valve Surgery

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Effects of transdermal magnesium chloride on quality of life for patients with fibromyalgia: a feasibility study

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Journal of Integrative Medicine 2015年第5期13卷 306-313页

作者： Deborah J.Engen Samantha J.Mc Allister Mary O.Whipple Stephen S.Cha Liza J.Dion Ann Vincent Brent A.Bauer Dietlind L.Wahner-Roedler Department of Physical Medicine and Rehabilitation Mayo Clinic Division of General Internal Medicine Mayo Clinic Division of Biomedical Statistics and Informatics Mayo Clinic

BACKGROUND： Fibromyalgia is a syndrome characterized by chronic pain, fatigue, depression, and sleep disturbances. Its primary cause is unclear. Several studies have reported decreased intracellular magnesium levels in patients with fibromyalgia and have found negative correlation between magnesium levels and fibromyalgia symptoms.OBJECTIVE： To gather preliminary data on whether transdermal magnesium can improve quality of life for women who have fibromyalgia. DESIGN, SETTING, PARTICIPANTS AND INTERVENTIONS： This is a patient questionnaires and survey in a fibremyalgia clinic at a tertiary medical center. Forty female patients with the diagnosis of fibremyalgia were enrolled. Each participant was provided a spray bottle containing a transdermal magnesium chloride solution and asked to apply 4 sprays per limb twice daily for 4 weeks. Participants were asked to complete the Revised Fibromyalgia Impact Questionnaire, SF-36v2 Health Survey, and a quality-of-life analog scale at baseline, week 2, and week 4. MAIN OUTCOME MEASURE： Questionnaire and survey scores, evaluated through intent-to-treat and per-protocol analyses. RESULTS： Twenty-four patients completed the study （mean [SD] age, 57.2 [7.6] years; white, 95%; mean body mass index, 31.3 kg/m2）. With intention-to-treat analysis, Revised Fibromyalgia Impact Questionnaire subscale and total scores were significantly improved at week 2 and week 4 （total score, P = 0.001）. Per-protocol analysis results were similar： all subscales of the Revised Fibremyalgia Impact Questionnaire were significantly improved at week 2 and week 4 （total score, P = 0.001）. CONCLUSION： This pilot study suggests that transdermal magnesium chloride applied on upper and lower limbs may be beneficial to patients with fibromyalgia.

关键词： fibromyalgia magnesium chloride Revised Fibromyalgia Impact Questionnaire clinical trial

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Low saturated fat diet is effective in trigeminal neuralgia

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Open Journal of Preventive Medicine 2013年第6期3卷 402-406页

作者： Narayan Verma Frank Sherwood BG Tricounty Neurology and sleep clinic Warren USA OUWB School of Medicine Warren USA

Objective: To determine the effectiveness of low saturated fat diet (LSFD) in patients with trigeminal neuralgia (TN). Design: 1) Internet forum where patients could request a 10 page LSFD plan, and 2) Follow-up assessment done by a retrospective 20-item questionnaire. Duration of treatment—2 months to 13 years. Pain rated on a Visual Analogue Scale and reported as typical, atypical, or both, defining typical TN as intermittent quick jolts/stabbing pain and atypical TN as continuous never ending discomfort. Setting: General community. Patients: 55 unselected patients, most with unilateral, severe and daily symptoms in V2 and V3 distribution for a mean duration of 8 years and on medications. 84% had pain level 9-10 before treatment, 89% had daily attacks and 31% had undergone surgical procedures. Intervention: LSFD for 2 months-13 years (mean 20 months). Main outcome measure: VAS score and medication use before and after LSFD treatment. Results: Reported SF content was 3-25 gm. With treatment 96% typical TN (p Conclusions: LSFD is effective in TN with high compliance, few adverse effects and may result in reduction/ elimination of medications even in most severe cases.

关键词： Trigeminal Neuralgia Low Saturated Fat Diet Cranial Neuropathy Neuralgia

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Obstructive sleep apnea-hypopnea syndrome immunological relationship

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World Journal of clinical Cases 2024年第27期12卷 6011-6014页

作者： Mahmoud Ali Alaa Ramadan Salim Surani Department of Medicine Al-Azhar UniversityDamietta 11651Egypt Department of Medicine South Valley UniversityQena 83523Egypt Department of Medicine and Pharmacology Texas A&M UniversityCollege StationTX 77843United States Department of Anesthesiology Mayo ClinicRochesterMN 55905United States

Obstructive sleep apnea-hypopnea syndrome(OSAHS)is a complex disorder cha-racterized by symptoms resulting from intermittent hypoxia and hypopnea,with research indicating a crucial role of immune system dysregulation and genetic variations in its pathogenesis.A recent Zhao et al study utilizes Mendelian ran-domization analysis to explore the causal relationship between immune cell characteristics and *** study identifies specific lymphocyte subsets as-sociated with OSAHS,providing valuable insights into the disease's pathophy-siology and potential targets for therapeutic *** findings underscore the significance of genetic and immunological factors in sleep disorders,offering a fresh perspective on OSAHS's *** to existing literature,Zhao et al's study stands out for its focus on genetic markers and specific immune responses associated with OSAHS,expanding upon previous research primarily centered on systemic *** conclusion,the study represents a signi-ficant advancement in the field,shedding light on the causal role of immune cells in OSAHS and paving the way for future research and targeted treatments.

关键词： Obstructive sleep apnea Mendelian randomization Lymphocyte charac-teristics Immunology Obstructive sleep apnea-hypopnea syndrome

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