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Autophagy Jan 2024AKI: acute kidney injury; ATP: adenosine triphosphate; BUN: blood urea nitrogen; CLP: cecal ligation and puncture; eGFR: estimated glomerular filtration rate; H&E:...
AKI: acute kidney injury; ATP: adenosine triphosphate; BUN: blood urea nitrogen; CLP: cecal ligation and puncture; eGFR: estimated glomerular filtration rate; H&E: hematoxylin and eosin staining; LCN2/NGAL: lipocalin 2; LPS: lipopolysaccharide; LTL: lotus tetragonolobus lectin; mKeima: mitochondria-targeted Keima; mtDNA: mitochondrial DNA; PAS: periodic acid - Schiff staining; RTECs: renal tubular epithelial cells; SAKI: sepsis-induced acute kidney injury; Scr: serum creatinine; SIRT3: sirtuin 3; TFAM: transcription factor A, mitochondrial; TMRE: tetramethylrhodamine.
Topics: Humans; Sirtuin 3; Melatonin; Mitophagy; Autophagy; Acute Kidney Injury; Lipopolysaccharides; DNA, Mitochondrial; Sepsis; Kidney; DNA-Binding Proteins; Transcription Factors; Mitochondrial Proteins
PubMed: 37651673
DOI: 10.1080/15548627.2023.2252265 -
JAAD Case Reports Jun 2022
PubMed: 35774223
DOI: 10.1016/j.jdcr.2022.05.013 -
BMC Gastroenterology Mar 2021Vaping, or e-cigarettes, heat nicotine and other chemicals to create a vapor that is inhaled. The practice has gained rapid popularity with 41 million people globally...
BACKGROUND
Vaping, or e-cigarettes, heat nicotine and other chemicals to create a vapor that is inhaled. The practice has gained rapid popularity with 41 million people globally reporting regular or occasional use. Although tobacco smoking is well-known to increase esophageal acid exposure by augmenting the number of reflux events, the effects of vaping on the gastrointestinal tract have not yet been elucidated. Our objective is to report a case of severe esophagitis associated with vaping, which is the first in the literature to our knowledge.
CASE PRESENTATION
A 25-year-old male with a history of well-controlled gastro-esophageal reflux disease presented to the emergency room for evaluation of one week of severe odynophagia. He had been treated with a proton-pump inhibitor for several years with good effect. Approximately two months prior to presentation, he started vaping tetrahydrocannabinol and nicotine with recent heavy daily use. He denied any alcohol or non-steroidal anti-inflammatory drug use. We performed esophagogastroduodenoscopy that revealed Los Angeles Grade C esophagitis (involving ≥ 1 mucosal breaks continuous between tops of ≥ 2 mucosal folds, < 75% circumferential). Histopathological analysis of esophageal biopsies demonstrated granulation tissue with acute and chronic inflammation. Periodic acid-Schiff-diastase staining was negative and immunohistochemical stains for herpes simplex virus and cytomegalovirus were negative. There was no evidence of eosinophilic esophagitis. We treated him with intravenous PPI and analgesics until he was able to tolerate oral intake. He was counseled extensively on vaping cessation and reported complete resolution of symptoms after 2 months.
CONCLUSION
This patient's presentation illustrates a serious gastrointestinal consequence of vaping, the long-term consequences of which warrant additional studies. Like smoking, the mechanism of injury in vaping may be, at least in part, due to the effects of nicotine. As prevalence of vaping continues to rise, clinicians should be aware of this complication and carefully solicit a patient's vaping history as a simple denial of "smoking" can be misleading.
Topics: Adult; Electronic Nicotine Delivery Systems; Esophagitis; Humans; Los Angeles; Male; Smoking; Vaping
PubMed: 33663409
DOI: 10.1186/s12876-021-01695-8 -
American Family Physician Oct 2021Onychomycosis is a chronic fungal infection of the fingernail or toenail bed leading to brittle, discolored, and thickened nails. Onychomycosis is not just a cosmetic... (Review)
Review
Onychomycosis is a chronic fungal infection of the fingernail or toenail bed leading to brittle, discolored, and thickened nails. Onychomycosis is not just a cosmetic problem. Untreated onychomycosis can cause pain, discomfort, and physical impairment, negatively impacting quality of life. Onychomycosis should be suspected in patients with discolored nails, nail plate thickening, nail separation, and foul-smelling nails. Accurate diagnosis is important before initiating treatment because therapy is lengthy and can cause adverse effects. A potassium hydroxide preparation with confirmatory fungal culture, periodic acid-Schiff stain, or polymerase chain reaction is the preferred diagnostic approach if confirmative testing is cost prohibitive or not available. Treatment decisions should be based on severity, comorbidities, and patient preference. Oral terbinafine is preferred over topical therapy because of better effectiveness and shorter treatment duration. Patients taking terbinafine in combination with tricyclic antidepressants, selective serotonin reuptake inhibitors, atypical antipsychotics, beta blockers, or tamoxifen should be monitored for drug-drug interactions. Topical therapy, including ciclopirox 8%, efinaconazole 10%, and tavaborole 5%, is less effective than oral agents but can be used to treat mild to moderate onychomycosis, with fewer adverse effects and drug-drug interactions. Nail trimming and debridement used concurrently with pharmacologic therapy improve treatment response. Although photodynamic and plasma therapies are newer treatment options that have been explored for the treatment of onychomycosis, larger randomized trials are needed. Preventive measures such as avoiding walking barefoot in public places and disinfecting shoes and socks are thought to reduce the 25% relapse rate.
Topics: Administration, Oral; Administration, Topical; Antifungal Agents; Diagnosis, Differential; Humans; Onychomycosis; Terbinafine
PubMed: 34652111
DOI: No ID Found -
Surgical Neurology International 2022Whipple disease (WD) is an infection caused by , which might present in three different forms: classical, localized, and isolated in the central nervous system (CNS). (Review)
Review
BACKGROUND
Whipple disease (WD) is an infection caused by , which might present in three different forms: classical, localized, and isolated in the central nervous system (CNS).
METHODS
We report the result of a systematic review of the literature on WD unusually presenting with exclusively neurological symptoms, including two previously unpublished cases. A description of two cases with isolated CNS WD was performed, as well as a literature search in , and .
RESULTS
Two male adult patients presented with exclusively neurological symptomatology. Both magnetic resonance imaging (MRI) showed an intracranial mass suggestive of brain tumor. The histopathological examination was consistent with WD, with no systemic involvement. In the review of the literature, 35 cases of isolated CNS WD were retrieved. The median age at diagnosis was 43.5 (IQR 31.5-51.5). In 13 patients, the MRI showed a brain mass consistent with a brain tumor. The most common finding in the biopsy was the periodic-acid Schiff-stained foamy macrophages. Only five cases presented the pathognomonic sign of oculomasticatory myorhythmia. Thirteen cases had an adverse outcome that resulted in death during follow-up, whereas another 13 improved. The other nine patients remained stable or presented moderate improvement.
CONCLUSION
Isolated CNS WD is a rare disease that should be considered among the differential diagnosis of CNS mass lesions. Brain biopsy is necessary to establish the diagnosis. It is stressed in the literature that an extended antibiotic course is required to prevent relapses and to control the disease.
PubMed: 36324907
DOI: 10.25259/SNI_591_2022 -
Frontiers in Oncology 2023The prevalence of gastric cancer has markedly declined, but due to the high mortality rates associated with gastric cancer, it is still a serious disease. The preferred... (Review)
Review
The prevalence of gastric cancer has markedly declined, but due to the high mortality rates associated with gastric cancer, it is still a serious disease. The preferred classification of gastric cancer is according to Lauren into either the intestinal type, which has a glandular growth pattern, or the diffuse type, which does not have glandular structures. Both types have been classified as adenocarcinomas, with the latter type based on periodic acid-Schiff (PAS) positivity presumed to reflect mucin. However, the presence of mucin in the diffuse type, in contrast to neuroendocrine/enterochromaffin-like (ECL) cell markers, has not been confirmed by immunohistochemistry and hybridization. The ECL cells are probably prone to becoming cancerous because they do not express E-cadherin. Gastric cancer is unique in that a bacterium, , is thought to be its main cause. predisposes infected individuals to cancer only after having caused oxyntic atrophy leading to gastric hypoacidity and hypergastrinemia. No single factor has been convincingly proved to be carcinogenic. It is probable that gastrin is the pathogenetic factor for gastric cancer due to , autoimmune gastritis, and long-term prolonged inhibition of gastric acid secretion. Hypergastrinemia induces ECL cell hyperplasia, which develops into neuroendocrine tumors (NETs) and then into neuroendocrine carcinomas in rodents, a sequence that has also been described in humans. During carcinogenesis, the tumor cells lose specific traits, requiring that sensitive methods be used to recognize their origin. Gastric cancer occurrence may hopefully be prevented by eradication at a young age, and by the reduced use of inhibitors of acid secretion and use of a gastrin antagonist in those with previous long-term infection and those with autoimmune gastritis.
PubMed: 37941554
DOI: 10.3389/fonc.2023.1176673 -
Cureus Jul 2023Whipple's disease is a rare systemic disease caused by a infection. Although older literature reports a low rate of incidence, case reports continue to rise due to...
Whipple's disease is a rare systemic disease caused by a infection. Although older literature reports a low rate of incidence, case reports continue to rise due to increased awareness of the disease. Classic Whipple's disease presents as weight loss, diarrhea, and arthralgia and may involve the heart, central nervous system (CNS), or any other organ system. Some patients with Whipple's disease do not have the classic signs and symptoms of the disease. We present a case of Whipple's disease in a patient with poor appetite, weight loss, and granulomatous inflammation of various organs, including the kidneys and spleen, mimicking sarcoidosis. She had presented three years earlier with acute kidney injury (AKI) and hypercalcemia. The renal biopsy revealed diffuse granulomatous interstitial nephritis. Both AKI and hypercalcemia resolved with prednisone; however, her weight loss and decreased appetite continued. The initial positron emission tomography (PET) scan showed increased fluorodeoxyglucose (FDG) avidity in the spleen and large intestine, and the splenic biopsy revealed non-caseating granulomas. A diagnosis of sarcoidosis was made, and she was started on methotrexate with prednisone. Nevertheless, the weight loss and poor appetite were relentless. A repeat PET scan showed increased FDG avidity in loops of the small and large intestines. A small intestinal biopsy revealed positive periodic acid-Schiff (PAS) and negative acid-fast bacilli (AFB) revealing the diagnosis of Whipple's disease. Whipple's disease should be considered in the differential diagnosis of sarcoidosis, especially in those patients worsening on standard immunosuppression.
PubMed: 37575808
DOI: 10.7759/cureus.41839 -
Genes & Diseases Nov 2022All-trans retinoic acid (ATRA) can reverse the malignant behaviors of hepatocellular carcinoma (HCC) cells, thereby exerting anti-HCC effect; however, the underlying...
All-trans retinoic acid (ATRA) can reverse the malignant behaviors of hepatocellular carcinoma (HCC) cells, thereby exerting anti-HCC effect; however, the underlying mechanism is yet to be understood. This study aimed to demonstrate that ATRA is vital to ferroptosis in HCC. Ferroptosis-related genes exhibit different expression in patients with HCC compared to that in healthy individuals. A total of 20 amino acid products were detected in HepG2 cells, the expression level of 5 was decreased after ATRA treatment. ATRA improved the levels of lipid ROS, MDA, and NAPD/NADPH, and reduced the mt-DNA copy number and changed the structure of mitochondria, in HepG2 and Hep3B cells. We found the expression of genes positively correlated with ferroptosis to increase and those negatively correlated to decrease with ATRA treatment. Inhibition of ferroptosis by Ferrostatin-1 reversed ATRA-inhibited proliferation of HCC cells, along with cell migration and invasion. GSH synthesis was blocked by ATRA, accompanied by decreased cystine content and increased glutamate content, and downregulation of the expression of GSH synthesis-related genes. Our findings suggested that ATRA inhibited the malignancy of HCC cells by improving ferroptosis, and that inhibition of GSH synthesis contributed to ATRA-induced ferroptosis.
PubMed: 36157492
DOI: 10.1016/j.gendis.2022.04.011 -
Journal of Parasitic Diseases :... Sep 2022The nematode parasite () has a global distribution and is commonly reported in rodents (definitive host), dogs, cats and wild animals. Humans especially children are...
The nematode parasite () has a global distribution and is commonly reported in rodents (definitive host), dogs, cats and wild animals. Humans especially children are more susceptible to the parasitic infection. This paper documents an incidental finding of hepatic calodiosis with cirrhosis in a stray dog and discusses the zoonotic implications. A non descript dog was brought for necropsy examination to the Department of Veterinary Pathology, Madras Veterinary College, Tamil Nadu, India. Liver appeared dark brown, mottled with multifocal random variably sized, grey white flat firm areas. Histopathologically, liver tissue revealed multiple random encysted large collection of eggs surrounded by mild inflammation with a few lymphocytes, macrophages and fine fibrosis. The eggs had characteristic barrel shape, bipolar ends, bilayered wall, cross striations between the walls, and yolk. Periodic acid Schiff stain demonstrated the glycolic wall of ova. Marked portal to portal fibrosis was demonstrated by Masson's trichrome (for collagen) and by Warthin-Starry (for reticulin) stains. The stage of parasitic infection was diagnosed as intermediate to chronic due to fibrosis. A need to study the prevalence of the disease in rodents, human and animals is emphasized. Improper burial of carcasses of rodents and dogs may contribute to spread of infection. Pets and stray animals may transmit infection to human and pose health risk.
PubMed: 36091291
DOI: 10.1007/s12639-022-01501-6 -
BMC Ophthalmology Mar 2021To report sampling of the trabecular meshwork using the TrabEx+ (MicroSurgical Technology, Redmond, Washington, USA) device in ab interno trabeculectomy. Specifically,...
BACKGROUND
To report sampling of the trabecular meshwork using the TrabEx+ (MicroSurgical Technology, Redmond, Washington, USA) device in ab interno trabeculectomy. Specifically, this series focusses upon preservation of the trabecular meshwork architecture for assessment of glaucomatous features using common histopathological techniques.
PATIENTS
This series features six glaucomatous eyes undergoing TrabEx+ with or without cataract surgery. Three patients had primary open angle glaucoma and the remaining had pigment dispersion glaucoma, ocular hypertension or uveitic glaucoma. Four eyes had simultaneous cataract surgery.
METHODS
Trabecular meshwork was excised using the TrabEx+ device and retrieved using vitreoretinal forceps. The samples were then processed into formalin-fixed paraffin-embedded 4 micron tissue segments and stained with haematoxylin and eosin, periodic acid-Schiff and elastin Van Gieson. Collagen IV was labelled using immunohistochemistry for the purpose of identifying the basement membrane of trabecular beams.
RESULTS
Presence of trabecular meshwork was confirmed in five of the six samples taken. One of six samples consisted of blood only, but this was expected following early termination of the procedure due to patient restlessness. In the five positive cases trabecular beams with associated trabecular meshwork cells were identified on hematoxylin-eosin and periodic acid-Schiff staining. The beams retained their lamellar structure. The basement membrane underlying the trabecular cells was evident in three specimens, whilst two specimens were of insufficient size for collagen IV labelling.
CONCLUSIONS
This case series illustrates that TrabEx+ can be utilised to successfully retrieve trabecular meshwork samples with sufficient architectural perseveration of the tissue to enable histopathological and laboratory analysis.
Topics: Glaucoma; Glaucoma, Open-Angle; Humans; Sclera; Trabecular Meshwork; Trabeculectomy
PubMed: 33740938
DOI: 10.1186/s12886-021-01895-6