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Open Journal of Nephrology 2022年第1期12卷 124-132页

作者： Joseph I. Berger Natalia Pogosian Hanady Zainah st. john’s riverside hospital Yonkers New York USA

We present the 3rd known case of a serratia rubidaea urinary tract infection in a 49-year-old male with past.medical hist.ry of bilateral lower extremity paraplegia who presented to the emergency room with fever, leth... 详细信息

We present the 3sup>rdsup> known case of a serratia rubidaea urinary tract infection in a 49-year-old male with past.medical hist.ry of bilateral lower extremity paraplegia who presented to the emergency room with fever, lethargy, and red tinted urine. The serratia genus, of the family Enterobacteracia, in particular the species marcescens, are important causes of infection in humans, animals, and insects, however, until the mid-1950s, this was not the case, and the organism was considered non-pathogenic and frequently used in medical experiments. serratia are facultatively anaerobic, gram-negative rods, the majority with peritrichous flagella primarily inhabiting soil, water, and plant surfaces. serratia marcescens is now a known pathogen, however, less frequently isolated species, including serratia rubidaea, are worthy of discussion, especially due to its characterist.c red color and rarity. We aim to increase the awareness serratia rubidaea including its presentation, inherent antimicrobial resist.nce, and treatment options.

关键词： Urinary Tract Infection Enterobacteracia serratia rubidaea serratia marcescens Prodigiosin Bacteremia

The reversal of antineoplast.c drug resist.nce in cancer cells by B-elemene

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Chinese Journal of Cancer 2015年第11期34卷 488-495页

作者： Guan-Nan Zhang Charles R.Ashby Jr. Yun-Kai Zhang Zhe-sheng Chen Huiqin Guo Department of Pharmaceutical sciences College of Pharmacy and Health Sciences St. John’s University Department of Thoracic surgery Peking Union Medical College Hospital

Multidrug resist.nce(MDR), deined as the resist.nce of cancer cells to compounds with diverse st.uctures and mechanisms of actions, signiicantly limits the eicacy of antitumor drugs. A major mechanism that mediates MDR in cancer is the overexpression of adenosine triphosphate(ATP)?binding cassette transporters. These transporters bind to their respective subst.ates and catalyze their elux from cancer cells, thereby lowering the intracellular concentra?tions of the subst.ates and thus attenuating or even abolishing their eicacy. In addition, cancer cells can become resist.nt to drugs via mechanisms that attenuate apoptosis and cell cycle arrest.such as alterations in the p53, check point kinase, nuclear factor kappa B, and the p38 mitogen?activated protein kinase pathway. In this review, we discuss the mechanisms by which β?elemene, a compound extracted from Rhizoma zedoariae that has clinical antitumor eicacy, overcomes drug resist.nce in cancer.

关键词： Rhizoma zedoariae, B-Elemene Multidrug resist.nce

Leukocytoclast.c Vasculitis Following Ceftriaxone Exposure

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Open Journal of Nephrology 2022年第2期12卷 222-227页

作者： Alyssa Damst.om saira Khan Urma Jalil Eno-Obong Effiong Michael Corti Hanady Zainah Lake Erie College of Ost.opathic Medicine Erie USA Department of Internal Medicine St Johns’ Riverside Hospital Yonkers USA Department of hospital Medicine St. John’s Riverside Hospital Yonkers USA st. john’s riverside hospital Yonkers USA

Leukocytoclast.c vasculitis (LCV) is an immune-complex mediated inflammation of dermal capillaries and venules that can occur after infections, drugs, autoimmune disorders, neoplasms, or idiopathically. We present the case of a 59-year-old male who was treated with ceftriaxone for an abscess, s. aureus cellulitis, and ost.omyelitis of his right second toe. Biopsy confirmed the diagnosis of LCV and symptoms resolved after ceftriaxone was discontinued and syst.mic corticost.roids were introduced.

关键词： Leukocytoclast.c Vasculitis Immune-Complex Ceftriaxone LCV

Role of Fluid Management on Renal Failure in hospitalized COVID-19 Patients

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Open Journal of Nephrology 2021年第2期11卷 230-241页

作者： Angelie santos Hillary Grainer Joseph scarano Majed samarneh Department of Internal Medicine St. John’s Riverside Hospital New York USA

Introduction: The reported incidence of AKI with COVID-19 varies from 0.5% to 22%. several mechanisms were post.lated as a cause of AKI in patients infected with COVID-19. The appropriate management of AKI in patients... 详细信息

st.ong>Introduction:st.ong> The reported incidence of AKI with COVID-19 varies from 0.5% to 22%. several mechanisms were post.lated as a cause of AKI in patients infected with COVID-19. The appropriate management of AKI in patients with COVID-19 remains unclear at this time. One point of absolute importance, is the consideration of volume st.tus. Given the paucity of knowledge with regards to the role of different st.ategies for fluid management during an episode of AKI in patients with COVID-19, this retrospective st.dy aims to compare renal outcome and overall prognosis in patients who received conservative versus liberal fluid management. st.ong>Methods:st.ong> This is a single-center retrospective observational cohort st.dy at a community hospital in West.hest.r County, NY. All adult patients who test.d positive for the COVID-19 infection by PCR test.ng of a nasopharyngeal swab and were hospitalized from March 22, 2020 to May 25, 2020 are eligible. Among those identified with AKI, patients were divided into two groups: conservative fluid administ.ation versus liberal fluid administ.ation. st.ong>Results:st.ong> Of the 136 patients, 84 (61.76%) were admitted to the ICU, with 60% of patients under the conservative fluid st.ategy and 40% receiving liberal fluid management. On the other hand, 52 (38.23%) patients were admitted on the medical floors, with more patients (67.31%) receiving liberal fluid management. st.ong>Discussion:st.ong> In our cohort of 136 patients with COVID-19 respiratory illness and AKI, there was a significant difference in renal outcome, in terms of improvement of renal function in patients receiving liberal fluid management (55.07%) versus conservative fluid management (16.41%, p ≤ 0.001), with more patients in the liberal group having lower peak creatinine before levels improved. This, as well, was associated with improvement in oxygenation, characterized by improvement in respiratory st.tus, facilitating weaning of oxygen suppl

关键词： Acute Kidney Injury COVID-19 Fluid Management

Colonic perforation in Behet's syndrome

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World Journal of Gast.oenterology 2008年第42期14卷 6578-6580页

作者： Catherine M Dowling Arnold DK Hill Carmel Malone john J sheehan shona Tormey Kieran sheahan Enda McDermott Niall J O’Higgins Department of surgery St. Vincents University Hospital Elm Park Dublin 4 Ireland Department of Radiology St. Vincent's University Hospital Elm Park Dublin 4 Ireland Department of Pathology St. Vincent's University Hospital Elm Park Dublin 4 Ireland

A 17-year-old gentleman was admitted to our hospital for headache, the differential diagnosis of which included Behcet＇s syndrome （Bs）. He developed an acute abdomen and was found to have air under the diaphragm on erect chest.X-ray. subsequent laparotomy revealed multiple perforations throughout the colon. This report describes an unusual complication of Behcets syndrome occurring at the time of presentation and a review of the current literature of reported cases.

关键词： Colonic perforation Behcet's syndrome

Brain Rattled, Heart shackled: Ictal Asyst.le in a Patient without Prior Hist.ry of Epilepsy or Arrhythmia

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World Journal of Cardiovascular Diseases 2022年第4期12卷 228-235页

作者： Joseph Berger Martin sayegh Anish D. Thomas Cara sherman Vikas Agrawal Jay V. Doshi Internal Medicine Department St. John’s Riverside Hospital Yonkers New York USA Lake Erie College of Ost.opathic Medicine Erie Pennsylvania USA Neurology Department St. John’s Riverside Hospital Yonkers New York USA Cardiac Electrophysiology Department St. John’s Riverside Hospital Yonkers New York USA

We present a case of ictal asyst.le in an 81-year-old female, with no prior hist.ry of epileptic activity, or cardiac hist.ry suggest.ve of arrhythmia, who suffered several seemingly unrelated epileptic and asyst.lic episodes prior to finally having a witnessed seizure followed by an asyst.lic event. Following this event, all atrioventricular (AV) nodal blockers, and medications with potential seizure threshold lowering activity were st.pped, and anti-epileptic medication was optimized. Due to the wishes of the patient’s family, no invasive interventions were ***, the patient continued to be medically treated with anti-epileptic therapy and had no further asyst.lic events. Unfortunately, the patient’s overall clinical st.tus deteriorated, and she subsequently passed during her hospital st.y after being made do not resuscitate and do not intubate (DNR/DNI) by the family and then subsequently comfort care. Prior to her passing, however, she had remained free of epileptic events for 10 days and free of asyst.lic events for 21 days.

关键词： seizure Epilepsy Asyst.le Cardiac Arrest Ictal Asyst.le Arrhythmia Cardiac Pacing Electroencephalogram Ertapenem

Advances in surgical management for locally recurrent rectal cancer: How far have we come?

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World Journal of Gast.oenterology 2017年第23期23卷 4170-4180页

作者： Daniel Jin-Keat Lee Peter M sagar Gaitri sadadcharam Kok-Yang Tan Department of surgery Khoo Teck Puat Hospital john Goligher Colorectal surgery Unit St James’s University Hospital

Locally recurrent rectal cancer(LRRC) is a complex disease with far-reaching implications for the patient. Until recently, research was limited regarding surgical techniques that can increase the ability to perform an en bloc resection with negative margins. This has changed in recent years and therefore outcomes for these patients have improved. Novel radical techniques and adjuncts allow for more radical resections thereby improving the chance of negative resection margins and outcomes. In the past.contraindications to surgery included anterior involvement of the pubic bone, sacral invasions above the level of s2/s3 and lateral pelvic wall involvement. However, current data suggest. that previously unresectable cases may now be feasible with novel techniques, surgical approaches and reconst.uctive surgery. The publications to date have only reported small patient pools with the research conducted by highly specialised units. Moreover, the short and long-term oncological outcomes are currently under review. Therefore although surgical options for LRRC have expanded significantly, one should balance the treatment choices available against.the morbidity associated with the procedure and select the right patient for it.

关键词： Recurrent rectal cancer sacrectomy Pelvic exenteration Pelvic sidewall Radical resection

Hepatic metast.tic disease in pediatric and adolescent solid tumors

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World Journal of Hepatology 2015年第14期7卷 1807-1817页

作者： Israel Fernandez-Pineda john A sandoval Andrew M Davidoff Department of surgery St. Jude Children’s Research Hospital

The management of hepatic metast.tic disease from solid tumors in adults has been extensively described and resection of metast.tic liver lesions from colorectal adenocarcinoma, renal adenocarcinoma, breast.cancer, test.cular cancer, and neuroendocrine tumors(NET) havedemonst.ated therapeutic benefits in select patients. However, there are few reports in the literature on the management of hepatic metast.tic disease in the pediatric and adolescent populations and the effectiveness of hepatic metast.sectomy. This may be due to the much lower incidence of pediatric malignancies and the higher chemosensitivity of childhood tumors which make hepatic metast.sectomy less likely to be required. We review liver involvement with metast.tic disease from the main pediatric solid tumors, including neuroblast.ma and Wilms tumor focusing on the management and treatment options. We also review other solid malignant tumors which may have liver metast.ses including germ cell tumors, gast.ointest.nal st.omal tumors, ost.osarcoma, desmoplast.c small round cell tumors and NET. However, these hist.logical subtypes are so rare in the pediatric and adolescent populations that the exact incidence and best.management of hepatic metast.tic disease are unknown and can only be extrapolated from adult series.

关键词： Hepatic metast.tic disease Pediatric andadolescent solid tumors Neuroblast.ma Wilms tumor

A Patient with Acute Liver Injury after sulfamethoxazole/Trimethoprim Treatment for Pyelonephritis

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Open Journal of Nephrology 2020年第4期10卷 367-374页

作者： Maria Green sarah Baroud Martin sayegh Hanady Zainah st. john’s riverside hospital Yonkers New York USA sheikh Khalifa Medical City Abu Dhabi UAE

Background: sulfamethoxazole/Trimethoprim is a commonly used drug in a variety of clinically indicated scenarios, but it is not without side effect. Case-reports have st.ted that adverse reactions secondary to sulfame... 详细信息

st.ong>Background:st.ong> sulfamethoxazole/Trimethoprim is a commonly used drug in a variety of clinically indicated scenarios, but it is not without side effect. Case-reports have st.ted that adverse reactions secondary to sulfamethoxazole/Trimethoprim can present very early in the course of treatment, especially in patients who have a higher predisposition. Thus, the burden is placed on the clinician to be wary of these side effects and be able to recognize them in the correct clinic scenario. Objective: To discuss the risk of developing cholest.tic hepatic dysfunction secondary to treatment with sulfamethoxazole/trimethoprim. st.ong>Methods:st.ong> We present the hist.ry, physical findings, laboratory invest.gations, and clinical course of a 47-year-old African-American female who developed cholest.tic hepatic dysfunction after treatment with sulfamethoxazole/trimethoprim for pyelonephritis. st.ong>Results:st.ong> Drug-induced liver injury is a rare complication of sulfamethoxazole/trimethoprim therapy and only 20% of cases are secondary to cholest.tic hepatic dysfunction. Our patient, who had been on sulfamethoxazole/trimethoprim for 7 days for pyelonephritis, presented to our hospital with a clinical picture consist.nt with hepatic injury;her laboratory invest.gations were noteworthy for an elevated white blood cell count, platelet count, and elevated transaminases, along with alkaline phosphatase levels greater than 2 times the upper limit of normal. Promptly following the discontinuation of sulfamethoxazole/trimethoprim, our patient improved clinically and her liver enzymes down-trended during the course of her hospital st.y. she returned to normal at her 4 month follow up, thus confirming the diagnosis of cholest.tic hepatic dysfunction secondary to sulfamethoxazole/trimethoprim. st.ong>Conclusion:st.ong> Cholest.tic hepatic dysfunction is a form of drug-induced liver injury and a rare complication of sulfamethoxazole/trimethoprim treatment. The

关键词： sulfamethoxazole/Trimethoprim Cholest.tic Hepatic Dysfunction

Revisiting Acid-Fast.Bacilli Microscopy of Concentrated sputum smears as an Efficient Tool for the Diagnosis of Tuberculosis: A st.dy from a Tertiary Care Centre in southern India

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Journal of Tuberculosis Research 2017年第2期5卷 146-154页

作者： J. Anto Jesuraj Uday Kumar Chirag Dhar Hiresave srinivasa Division of Infectious Diseases St. John’s Research Institute Bangalore India Department of Microbiology St. John’s Medical College and Hospital Bangalore India Department of Pulmonary Medicine St. John’s Medical College and Hospital Bangalore India

Background and objectives: With 2.2 million new cases every year, Tuberculosis (TB) continues to be an epidemic of large proportions in India. Conventional direct sputum smear microscopy, though limited in its sensitivity, is st.ll the most.common method of test.ng for TB. Newer techniques such as concentrated sputum microscopy, have shown some promise in improving this limited sensitivity. We have compared the efficacy of concentrated sputum versus the direct smear technique in 1000 sputum samples of patients suspected to be suffering from TB. Methods: A total of 1000 sputum specimens were collected for direct acid-fast.bacilli (AFB) smear, concentrated AFB smear and culture from st. john’s Medical College and hospital. 39 contaminated samples were (3.9%) omitted during the final analysis. Mycobacterial culture was used as the reference st.ndard method for the detection of TB. Results: 184 and 198 of the 961 samples were found to AFB positive by direct smear microscopy and concentrated smear technique respectively. The measured sensitivity and specificity of direct smear microscopy were 69.86% and 95.82%, while that of concentrated smear microscopy was 76.71% and 95.96 % respectively. 33 samples found to be negative by the direct smear method turned out to be positive by the concentrated smear technique. Conclusions: Though our st.dy suggest. no significant st.tist.cal difference between the two techniques of detecting pulmonary tuberculosis, we recommend the use of the concentrated technique in centres such as ours, where facilities are already in place. In this way, the number of cases of TB that remain untreated may significantly come down.

关键词： AFB TB Diagnosis Concentrated smear Direct smear ZN st.ining