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Echocardiographic predictors and associated outcomes of multiple vegetations in infective endocarditis:A pilot study

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World Journal of Cardiology 2024年第6期16卷 318-328页

作者： Ajay Kumar Mishra Kannu Bansal Ibragim Al-Seykal Pradnya B Bhattad Anu Anna George Anil Jha Nitish Sharma Jennifer Sargent Mark J Kranis Division of Cardiology Saint Vincent HospitalWorcesterMA 01608United States Department of Internal Medicine Saint Vincent HospitalWorcesterMA 01608United States Department of Medicine Division of CardiologySaint Vincent HospitalWorcesterMA 01608United States Division of Cardiovascular Medicine Saint Vincent HospitalWorcesterMA 01608United States

BACKGROUND Infective endocarditis(IE)is a life-threatening infection with an annual mortality of 40%.Embolic events reported in up to 80%of *** of>10 mm size are associated with increased embolic events and poor *** is a paucity of literature on the association of multiple vegetations with *** To study the echocardiographic(ECHO)features and outcomes associated with the presence of multiple *** In this retrospective,single-center,cohort study patients diagnosed with IE were recruited from June 2017 to June 2019.A total of 84 patients were diagnosed to have IE,of whom 67 with vegetation were *** demographic,clinical,laboratory,and ECHO parameters were *** that were studied included recurrent admission,embolic phenomenon,and *** Twenty-three(34%)patients were noted to have multiple vegetations,13(56.5%)were male and 10(43.5%)were *** mean age of these patients was ***(35%)had a prior episode of *** features of moderate to severe valvular regurgitation[odds ratio(OR)=4],presence of pacemaker lead(OR=4.8),impaired left ventricle(LV)relaxation(OR=4),and elevated pulmonary artery systolic pressure(PASP)(OR=2.2)are associated with higher odds of multiple *** these moderate to severe valvular regurgitation(P=0.028),pacemaker lead(P=0.039)and impaired relaxation(P=0.028)were statistically *** patients were noted to have an increased association of recurrent admissions(OR=3.6),recurrent bacteremia(OR=2.4),embolic phenomenon(OR=2.5),intensive care unit stay(OR=2.8),hypotension(OR=2.1),surgical intervention(OR=2.8)and device removal(OR=4.8).Of this device removal(P=0.039)and recurrent admissions(P=0.017)were statistically *** This study highlights the associations of ECHO predictors and outcomes in patients with IE having multiple *** features of moderate to severe regurgitation,presence of pacemaker lead,impai

关键词： Endocarditis Echocardiography Vegetations Predictors Outcome

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New insights into ATR inhibition in muscle invasive bladder cancer:The role of apolipoprotein B mRNA editing catalytic subunit 3B

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Oncology Research 2024年第6期32卷 1021-1030页

作者： HYUNHO KIM UIJU CHO SOOK HEE HONG HYUNG SOON PARK IN-HO KIM HO JUNG AN BYOUNG YONG SHIM JIN HYOUNG KANG Division of Medical Oncology Department of Internal MedicineSt.Vincent’s HospitalCollege of MedicineThe Catholic University of KoreaSuwonKorea Department of Pathology St.Vincent’s HospitalCollege of MedicineThe Catholic University of KoreaSuwonKorea Division of Medical Oncology Department of Internal MedicineSeoul St.Mary’s HospitalCollege of MedicineThe Catholic University of KoreaSeoulKorea

Background:Apolipoprotein B mRNA editing catalytic polypeptide(APOBEC),an endogenous mutator,induces DNA damage and activates the ataxia telangiectasia and Rad3-related(ATR)-checkpoint kinase 1(Chk1)*** cisplatin-based therapy is the mainstay for muscle-invasive bladder cancer(MIBC),it has a poor survival ***,this study aimed to evaluate the efficacy of an ATR inhibitor combined with cisplatin in the treatment of APOBEC catalytic subunit 3B(APOBEC3B)expressing ***:Immunohistochemical staining was performed to analyze an association between APOBEC3B and ATR in patients with *** APOBEC3B expression in MIBC cell lines was assessed using real-time polymerase chain reaction and western blot *** blot analysis was performed to confirm differences in phosphorylated Chk1(pChk1)expression according to the APOBEC3B *** viability and apoptosis analyses were performed to examine the anti-tumor activity of ATR inhibitors combined with ***:There was a significant association between APOBEC3B and ATR expression in the tumor tissues obtained from patients with *** with higher APOBEC3B expression showed higher pChk1 expression than cells expressing low APOBEC3B *** treatment of ATR inhibitor and cisplatin inhibited cell growth in MIBC cells with a higher APOBEC3B *** to cisplatin single treatment,combination treatment induced more apoptotic cell death in the cells with higher APOBEC3B ***:Our study shows that APOBEC3B’s higher expression status can enhance the sensitivity of MIBC to cisplatin upon ATR *** result provides new insight into appropriate patient selection for the effective application of ATR inhibitors in MIBC.

关键词： Apolipoprotein B mRNA editing catalytic polypeptide(APOBEC) Ataxia telangiectasia and Rad3-related(ATR) Bladder cancer DNA damage response DNA replication stress

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Paradigm shift in transfusion practices during early COVID-19 pandemic:A single center retrospective study

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World Journal of Virology 2024年第2期13卷 78-86页

作者： Sumukh Arun Kumar Sushmita Prabhu Ankushi Sanghvi Maya Gogtay Mithil Gowda Suresh Harshit Khosla Yuvaraj Singh Ajay Kumar Mishra Susan George Department of Internal Medicine Saint Vincent HospitalWorcesterMA 01608United States Department of Hematology and Oncology University of Nebraska Medical CenterOmahaNE 68198United States Hospice and Palliative Care UTHSC and McGovern School of MedicineTexasTX 77030United States Department of Gastroenterology and Hepatology UMass Chan Medical SchoolWorcesterMA 01655United States Division of Cardiology Saint Vincent HospitalWorcesterMA 01608United States

BACKGROUND The advent of coronavirus disease 2019(COVID-19)unveiled the worst national blood crisis that the United States had witnessed in over a *** the pandemic influencing the different stages of the acquisition of blood products outside the hospital setting,we aimed to explore the possible barriers contributing to the shortage of blood products within the medical *** COVID era and pre-COVID *** We conducted a retrospective cross-sectional study on hospitalized patients distinguishing the pattern of blood transfusion during the COVID and pre-COVID era in a community *** was tabulated to include the number of red blood cell(RBC)transfusions and if transfusions met restrictive blood transfusion criteria as per institutional ***-square was applied to test the statistical association between qualitative *** t test and Mann Whitney U test were applied respectively to test the mean difference of quantitative *** A total of 208 patients were included in the study,of which 108 were during COVID era and 100 were during pre-COVID *** leading reason for admission in both the COVID era and pre-COVID era transfused patients was shortness of breath(53.7%and 36%P=0.001),followed by gastrointestinal bleeding(25.9%and 21%P=0.001).There was a higher percentage of RBC transfusions in the intensive care unit in the COVID-era group than in the pre-COVID era group(38.9%vs 22%,P=0.008).The restrictive transfusion criteria were met in 62%vs 79%in the COVID and pre-COVID eras,respectively(P=0.008).CONCLUSION The COVID-era group received RBC transfusions with less stringent adherence to restrictive blood transfusion practices in comparison to pre-COVID era group.

关键词： Blood transfusion Restrictive transfusion COVID-19 Pre-COVID-19 Blood shortage Pandemic

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New guidelines for screening,evaluation and management of hepatobiliary disease in cystic fibrosis

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Hepatobiliary Surgery and Nutrition 2024年第5期13卷 875-878页

作者： P.Aiden McCormick Emer Fitzpatrick Liver Unit St Vincent’s University HospitalDublinIreland Department of Medicine UCD School of MedicineUniversity College DublinDublinIreland Gastroenterology and Liver Department Children’s Health IrelandCrumlinDublinIreland

The recently published guidelines on screening,monitoring and treatment update previous guidelines published 25 years ago(1,2).This update is timely as much has happened in the *** fibrosis(CF)modulator therapy has dramatically improved prognosis for patients with CF,although it is not yet clear whether liver disease is *** understanding of the pathophysiology of CF liver disease has also changed with the recognition of the importance of non-cirrhotic portal hypertension(3,4).Non-invasive tests for fibrosis and elastography have changed the practice of hepatology and reduced the need for liver *** guideline committee was made up of experts from North America and Europe and included adult and paediatric hepatologists and pulmonologists together with allied health practitioners and representatives of the CF community.A systematic literature search was performed and a vote of 80%was required to adopt a *** guidelines contain 7 recommendations for screening,13 for disease monitoring and 14 for treatment.

关键词： Cirrhosis oesophageal varices non-cirrhotic portal hypertension porto-sinusoidal vascular disease hepatobiliary

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Classification of musical hallucinations and the characters along with neural-molecular mechanisms of musical hallucinations associated with psychiatric disorders

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World Journal of Psychiatry 2024年第9期14卷 1386-1396页

作者： Xin Lian Wei Song Tian-Mei Si Naomi Zheng Lian Department of Radiology and Biomedical Imaging Shanxi Bethune HospitalShanxi Academy of Medical SciencesTaiyuan 030032Shanxi ProvinceChina Department of Psychiatry and Behavioral Neurosciences McMaster UniversityHamilton L8S 4L8ONCanada Department of Psychopharmacology Peking University Sixth HospitalBeijing 100191China Department of Psychiatry Hartford HealthCareSt Vincent’s Medical CenterWestportCT 06088United States

BACKGROUND Musical hallucinations(MH)involve the false perception of music in the absence of external stimuli which links with different *** pathomechanisms of MH encompass various *** etiological classification of MH is of particular importance and offers valuable insights to understand MH,and further to develop the effective treatment of *** the recent decades,more MH cases have been reported,revealing newly identified medical and psychiatric causes of *** imaging studies reveal that MH activates a wide array of brain *** up-to-date analysis on MH,especially on MH comorbid psychiatric conditions is *** To propose a new classification of MH;to study the age and gender differences of MH in mental disorders;and neuropathology of *** Literatures searches were conducted using keywords such as“music hallucination,”“music hallucination and mental illness,”“music hallucination and gender difference,”and“music hallucination and psychiatric disease”in the databases of PubMed,Google Scholar,and Web of *** cases were collected and categorized based on their *** t-test and ANOVA were employed(P<0.05)to compare the age differences of MH different etiological *** neuroimaging studies of neural networks regulating MH and their possible molecular mechanisms were *** Among the 357 yielded publications,294 MH cases were *** average age of MH cases was 67.9 years,with a predominance of females(66.8%females vs 33.2%males).MH was classified into eight groups based on their etiological *** analysis of MH cases indicates varying associations with psychiatric *** We carried out a more comprehensive review of MH *** the first time according to our knowledge,we demonstrated the psychiatric conditions linked and/or associated with MH from statistical,biological and molecular point of view.

关键词： Pathomechanism Etiological factors Classification Gender difference Neuropathway Psychotic musical hallucination and non-psychotic musical hallucination Neuropathway Biological and molecular mechanism

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Retrospective study evaluating association of colorectal tumors and hepatitis C virus

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World Journal of Virology 2024年第3期13卷 56-64页

作者： Maya Gogtay Lekha Yadukumar Yuvaraj Singh Mithil Gowda Suresh Aakriti Soni Anuroop Yekula Asha Bullappa George M Abraham Department of Hematology and Oncology Internal MedicineUniversity of Nebraska Medical CenterOmahaNE 68198United States Department of Internal Medicine The Wright Center for Graduate Medical EducationScrantonPA 18505United States Department of Gastroenterology and Hepatology University of Massachusetts Chan Medical SchoolWorcesterMA 01605United States Department of Internal Medicine Saint Vincent HospitalWorcesterMA 01608United States Department of Internal Medicine St.Vincent HospitalWorcesterMA 01608United States Department of Community Medicine SS Institute of Medical Sciences and Research CentreDavangere 577003KarnatakaIndia

BACKGROUND Chronic hepatitis C virus(HCV)has been associated with hepatic and extrahe-patic *** studies have shown an association between colorectal adenomas and HCV *** To study the prevalence of colorectal adenomas in patients with HCV compared to the general population and to evaluate if it is an independent risk factor for colorectal *** Patients were divided into HCV and non-HCV based on their HCV RNA *** with alcoholic liver disease,hepatitis B infection,and inflammatory bowel disease were *** variables were analyzed using the Mann-Whitney U test,and categorical variables usingχ^(2) with P<0.05 were considered statistically *** significant covariates(independent variables)were matched in both groups by propensity score matching,followed by multivariate regression *** Of the 415 patients screened,109 HCV patients and 97 non-HCV patients with colonoscopy results were included in the *** patients were older,had a smoking history,had less frequent aspirin use,and had a lower body mass index(BMI)(P<0.05).The HCV cohort had a significantly increased number of patients with adenomas(adenoma detection rate of 53.2%vs 34%.P=0.006).We performed a propensity-matched multivariate analysis where HCV infection was significantly associated with colorectal adenoma(OR:2.070,P=0.019).CONCLUSION Our study shows a significantly higher rate of adenomas in HCV patients compared to the general *** studies would help determine if the increase in adenoma detection lowers the risk for colorectal cancer.

关键词： Hepatitis C Colon cancer Adenoma Polyps Colonoscopy

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Prevalence of nonalcoholic fatty liver disease in pediatrics and adolescents:a systematic review and meta-analysis

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World Journal of Pediatrics 2024年第6期20卷 569-580页

作者： Eun Joo Lee Miyoung Choi Sang Bong Ahn Jeong-Ju Yoo Seong Hee Kang Yuri Cho Do Seon Song Hong Koh Dae Won Jeon Hye Won Lee Department of Pediatrics Yonsei University College of MedicineSeoulKorea Clinical Evidence Research National Evidence-Based Healthcare Collaborating Agency(NECA)SeoulKorea Department of Internal Medicine Nowon Eulji Medical CenterEulji University College of MedicineSeoulKorea Department of Internal Medicine Soonchunhyang University Bucheon HospitalBucheonKorea Department of Internal Medicine Sangkye Paek HospitalInje University College of MedicineSeoulKorea Center for Liver and Pancreatobiliary Cancer National Cancer CenterGoyangKorea Department of Internal Medicine College of MedicineSt.Vincent's HospitalThe Catholic University of KoreaSuwonKorea Department of Internal Medicine Hanyang University College of MedicineSeoulKorea Department of Internal Medicine Yonsei University College of MedicineSeoulKorea

Background As childhood obesity escalates worldwide,the prevalence of nonalcoholic fatty liver disease(NAFLD)in pediatric and adolescent populations is also ***,systematic studies and meta-analyses evaluating the prevalence of pediatric NAFLD remain *** The MEDLINE,Korean Medical Database(KMBASE),Embase,Global Health,and Cochrane Library databases were searched from January 1997 to April *** terms included NAFLD or steatosis;nonalcoholic or steatohepatitis;child(ren),adolescent,or teenager;and prevalence,incidence,or epidemiology.A random-effects meta-analysis model was used to estimate the prevalence of pediatric *** A total of 2116 publications were found,of which 62 were included in the *** them,27 reported the prevalence in the general population and 39 in the obese *** worldwide pooled prevalence of pediatric NAFLD was 13%[95%confidence interval(CI)9-18%]in the general population and 47%(95%CI 41%–53%)in the obese *** 16 studies in the general population and 18 in the obese population,NAFLD prevalence varied by *** the general population,the prevalence of NAFLD was 15%(95%CI 8%–23%)in males and 10%(95%CI 6%–15%)in *** the obese population,it was 54%(95%CI 46%–61%)in males and 39%(95%CI 30%–49%)in *** The global prevalence of pediatric NAFLD is rising in both the general and obese *** the increasing rates of childhood obesity,epidemiological studies on the prevalence and incidence of NAFLD are needed.

关键词： Meta-analysis Nonalcoholic fatty liver disease Pediatric Prevalence

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Acute cholangitis with Achromobacter xylosoxidans bacteremia after endoscopic retrograde cholangiopancreatography in hilar cholangiocarcinoma:A case report

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World Journal of Clinical Cases 2024年第20期12卷 4377-4383页

作者： Ik Hyun Jo Sung Woo Ko Department of Internal Medicine St.Vincent’s HospitalCollege of MedicineThe Catholic University of KoreaSeoul 16471South Korea Department of Internal Medicine Eunpyeong St.Mary’s HospitalCollege of MedicineThe Catholic University of KoreaSeoul 03312South Korea

BACKGROUND Achromobacter xylosoxidans is a Gram-negative opportunistic aerobe,usually causing nosocomial infections in immunocompromised patients with manifestations including bacteremia,pneumonia,and catheter-related ***,*** have not yet been reported to cause biliary system *** SUMMARY A 72-year-old woman presented to the outpatient department of our hospital with a chief complaint of *** tomography of her abdomen revealed the presence of a mass of approximately 2.4 cm in the hilar portion of the common hepatic duct,consistent with hilar *** performed endoscopic retrograde cholangiopancreatography(ERCP)to decompress the obstructed left and right intrahepatic ducts(IHDs)and placed 10 cm and 11 cm biliary stents in the left and right IHDs,***,the day after the procedure,the patient developed post-ERCP cholangitis as the length of the right IHD stent was insufficient for proper bile *** blood culture of the patient tested positive for *** measures included the replacement of the right IHD stent(11 cm)with a longer one(12 cm)and administering culturedirected antibiotic therapy,solving the cholangitis-related *** the cholangitis had resolved,the patient underwent surgery for hilar cholangiocarcinoma and survived for 912 d without *** ***-induced biliary system infections are extremely *** awareness of physicians and endoscopists is required as this rare pathogen might cause infection after endoscopic procedures.

关键词： Achromobacter xylosoxidans Bacteremia Cholangitis Endoscopic retrograde cholangiopancreatography Malignant biliary stricture Cholangiocarcinoma Case report

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Complete Hydatidiform Mole at Menopause: A Case Report from Panzi hospital, Bukavu, Democratic Republic of Congo

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Open Journal of Obstetrics and Gynecology 2024年第7期14卷 1010-1017页

作者： Julien Bwama De-Joseph Kakisingi Mibi Nsenga Bin Musa Jeff Andrea Mbozi Déborah Kambonesa Salire Dieudonné Kakusu Christine Amisi Tina Aroni Toto Tchass Chasinga Baharanyi Denis Mukwege Mukengere Olivier Nyakio Ngeleza Department of Gynaecology-Obstetrics Faculty of Medicine and Community Health Evangelical University in Africa Bukavu Democratic Republic of Congo Gynaecology-Obstetrics Department Panzi General Referral Hospital Bukavu Democratic Republic of Congo saint vincent hospital Bukavu Democratic Republic of Congo Medical Imaging Department Panzi General Referral Hospital Bukavu Democratic Republic of Congo Anatomopathology Department Panzi General Referral Hospital Bukavu Democratic Republic of Congo Panzi Foundation Bukavu Democratic Republic of Congo Department of Gynaecology-Obstetrics Faculty of Medicine Official University of Bukavu Bukavu Democratic Republic of Congo Department of Gynaecology-Obstetrics Faculty of Medicine University of Kindu Kindu Democratic Republic of Congo

Gestational trophoblastic disease is an abnormal proliferation of trophoblastic tissue during pregnancy. It occurs in women of childbearing age, although a few cases have also been observed in post-menopausal women, although it is extremely rare in the latter. Here we describe a rare case of complete hydatidiform mole in a 56-year-old female patient who presented with genital bleeding combined with nausea and vomiting and a gravid uterus 16 cm in height. The ultrasound findings and the increase in serum β-HCG to 182566.00 mIU/ml suggested a diagnosis of complete hydatidiform mole. Given the post-menopausal state and the future risk of post-molar gestational trophoblastic neoplasia, we opted for total hysterectomy without preservation of the adnexa via a transabdominal approach, followed by antimitotic treatment with methotrexate. The uterus measured 18.45 cm × 11.18 cm with intra cavitary vesicles. Microscopic examination showed chorionic villi of variable size and shape, most of which were dilated and oedematous, associated with trophoblastic cell proliferation and haemorrhage suggestive of complete benign hydatidiform mole. Follow-up showed a consistent decrease in serum β-HCG levels and no evidence of residual disease. A suspicion of gestational trophoblastic disease should be borne in mind when evaluating a patient with peri- or post-menopausal bleeding to avoid delay in diagnosis and treatment.

关键词： Complete Hydatidiform Mole Menopause β-HCG Panzi Bukavu DRC

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Effect of smoking on the risk of gastrointestinal cancer after cholecystectomy: A national population-based cohort study

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World Journal of Gastrointestinal Surgery 2024年第9期16卷 2796-2807页

作者： Minseob Kim Kyung-Do Han Seung-Hyun Ko Yoonkyung Woo Jae Hyun Han Department of Surgery Graduate School of MedicineThe Catholic University of KoreaSeoul 06591South Korea Department of Statistics and Actuarial Science Soongsil UniversitySeoul 06978South Korea Division of Endocrinology and Metabolism Department of Internal MedicineSt Vincent’s HospitalCollege of MedicineThe Catholic University of KoreaSuwon 16247South Korea Division of Hepatobiliary-Pancreas Surgery and Liver Transplantation Department of SurgerySt Vincent’s HospitalCollege of MedicineThe Catholic University of KoreaSuwon 16247South Korea

BACKGROUND The role of smoking in the incidence of colorectal cancer(CRC)or gastric cancer(GC)in populations undergoing cholecystectomy has not been *** To evaluate the effect of smoking on CRC or GC development in cholecystectomy *** A total of 174874 patients who underwent cholecystectomy between January 1,2010 and December 31,2017 were identified using the Korean National Health Insurance Service claims *** patients were matched 1:1 with mem-bers of a healthy population according to age and *** or GC risk after cholecystectomy and the association between smoking and CRC or GC risk in cholecystectomy patients were evaluated using adjusted hazard ratios(HRs)and 95%*** The risks of CRC(adjusted HR:1.15;95%CI:1.06-1.25;P=0.0013)and GC(adjusted HR:1.11;95%CI:1.01-1.22;P=0.0027)were significantly higher in cholecystectomy *** the population who underwent cholecystectomy,both CRC and GC risk were higher in those who had smoked compared to those who had never *** both cancers,the risk tended to increase in the order of non-smokers,ex-smokers,and current *** addition,a positive correlation was observed between the amount of smoking and the risks of both CRC and *** Careful follow-up and screening should be performed,focusing on the increased risk of gastrointestinal cancer in the cholecystectomy group,particularly considering the individual smoking habits.

关键词： Cholecystectomy Smoking,Gastric cancer Colon cancer Risk factor Hazard ratio

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