Cancer patients are at increased risk for severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)infection and mortality.Like other viruses in the SARS family,SARS-CoV-2 employs two host proteins,angiotensin-conve...Cancer patients are at increased risk for severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)infection and mortality.Like other viruses in the SARS family,SARS-CoV-2 employs two host proteins,angiotensin-converting enzyme 2(ACE2)and transmembrane serine protease 2(TMPRSS2),for viral entry.1 Recent studies showed that many of the host proteins identified as potential targets for developing COVID therapies are dysregulated in cancer,2 prompting us to investigate whether human cancer cells are susceptible to SARS-CoV-2 infection,and whether chemotherapy could modulate a cancer patient's risk for infection.展开更多
BACKGROUND: Micturition syncope is a relatively uncommon cause of sudden and temporary loss of consciousness. Most prevalent in older males, this condition is extremely rare in women. CASES: Two pregnant women present...BACKGROUND: Micturition syncope is a relatively uncommon cause of sudden and temporary loss of consciousness. Most prevalent in older males, this condition is extremely rare in women. CASES: Two pregnant women presented with recurrent syncope. The syncopal events were more common in the early morning and were precipitated by the presence of a distended bladder, urinary urgency, assuming a standing position after either being supine or sitting, or associated with travel motion. Extensive neurology and cardiology evaluations were negative, and the events were considered consistent with micturition syncope. Both patients responded favorably to conservative voiding behavior modification measures throughout the remainder of pregnancy. CONCLUSION: Micturition syncope during pregnancy may not be a rare occurrence. This potentially dangerous condition is amenable to voiding behavior modification measures.展开更多
Background: Pseudoxanthoma elasticum (PXE) is a systemic connective tissue disorder involving elastic fiber calcification and fragmentation with major clinicalmanifestations occurring in the cutaneous, ocular, and car...Background: Pseudoxanthoma elasticum (PXE) is a systemic connective tissue disorder involving elastic fiber calcification and fragmentation with major clinicalmanifestations occurring in the cutaneous, ocular, and cardiovascular systems. Normalization of the serum calcium-phosphate product through hemodialysis in a previous patient with perforating periumbilical PXE and elevated serum phosphate resulted in regression of skin lesions. Objective: We sought to study the effect of pharmacologically limiting the intestinal absorption of phosphate in patients with PXE. Methods: Patients received baseline skin examinations, target skin lesion evaluation, and photography; renal function tests and serum calcium and phosphate levels; urine calcium, phosphate, and creatinine levels; skin biopsy; and eye examinations and indocyanine-green angiography. Patients were treated with aluminium hydroxide tablets or liquid and returned every 2 to 4 months for skin photography and lesion evaluation. Repeated skin biopsies were performed on clinically improved target sites. Ophthalmologic evaluation was obtained at yearl y intervals. Results: Of 6 patients, 3 showed significant clinical improvement of skin lesions and all 3 of these patients showed histopathologic regression of disease in their target lesions. No deterioration of eye disease was seen in any of the 6 patients at 1-year follow-up. Conclusion: Our results demonstrate that the calcification seen in PXE may be reversible in some patients. This could hold true for eye and vascular lesions and for skin. Further studies supporting these results could reveal the first real treatment option for PXE.展开更多
A 43-year-old man with pancytopenia from chemotherapy for acute myeloid leukemia developed left scrotal pain, fever, and rigors. Physical exam revealed an ulcerating lesion with central necrosis and eschar surrounded ...A 43-year-old man with pancytopenia from chemotherapy for acute myeloid leukemia developed left scrotal pain, fever, and rigors. Physical exam revealed an ulcerating lesion with central necrosis and eschar surrounded by a halo of erythema on the inferior aspect of the left scrotum. The condition indicated an early necrofizing soft tissue infection. The patient was started on broad-spectrum antibiotics and taken to the operating room for a wound debridement. Blood and tissue cultures grew Pseudomonas aeruginosa, which confirmed the diagnosis of ecthyma gangrenosum of the scrotum. The fever resolved, and the wound healed without further progression after wet to dry dressing changes.展开更多
基金This project was supported by grants from the National Institutes of Health(No.R01 CA236356 and R01 CA213293)to Wei XuUniversity of Wisconsin Carbone Cancer Center Support Grant(No.P30 CA014520)Dr.Shengjie Zhang received partial salary support from the National Natural Science Foundation of China(No.81502603).
文摘Cancer patients are at increased risk for severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)infection and mortality.Like other viruses in the SARS family,SARS-CoV-2 employs two host proteins,angiotensin-converting enzyme 2(ACE2)and transmembrane serine protease 2(TMPRSS2),for viral entry.1 Recent studies showed that many of the host proteins identified as potential targets for developing COVID therapies are dysregulated in cancer,2 prompting us to investigate whether human cancer cells are susceptible to SARS-CoV-2 infection,and whether chemotherapy could modulate a cancer patient's risk for infection.
文摘BACKGROUND: Micturition syncope is a relatively uncommon cause of sudden and temporary loss of consciousness. Most prevalent in older males, this condition is extremely rare in women. CASES: Two pregnant women presented with recurrent syncope. The syncopal events were more common in the early morning and were precipitated by the presence of a distended bladder, urinary urgency, assuming a standing position after either being supine or sitting, or associated with travel motion. Extensive neurology and cardiology evaluations were negative, and the events were considered consistent with micturition syncope. Both patients responded favorably to conservative voiding behavior modification measures throughout the remainder of pregnancy. CONCLUSION: Micturition syncope during pregnancy may not be a rare occurrence. This potentially dangerous condition is amenable to voiding behavior modification measures.
文摘Background: Pseudoxanthoma elasticum (PXE) is a systemic connective tissue disorder involving elastic fiber calcification and fragmentation with major clinicalmanifestations occurring in the cutaneous, ocular, and cardiovascular systems. Normalization of the serum calcium-phosphate product through hemodialysis in a previous patient with perforating periumbilical PXE and elevated serum phosphate resulted in regression of skin lesions. Objective: We sought to study the effect of pharmacologically limiting the intestinal absorption of phosphate in patients with PXE. Methods: Patients received baseline skin examinations, target skin lesion evaluation, and photography; renal function tests and serum calcium and phosphate levels; urine calcium, phosphate, and creatinine levels; skin biopsy; and eye examinations and indocyanine-green angiography. Patients were treated with aluminium hydroxide tablets or liquid and returned every 2 to 4 months for skin photography and lesion evaluation. Repeated skin biopsies were performed on clinically improved target sites. Ophthalmologic evaluation was obtained at yearl y intervals. Results: Of 6 patients, 3 showed significant clinical improvement of skin lesions and all 3 of these patients showed histopathologic regression of disease in their target lesions. No deterioration of eye disease was seen in any of the 6 patients at 1-year follow-up. Conclusion: Our results demonstrate that the calcification seen in PXE may be reversible in some patients. This could hold true for eye and vascular lesions and for skin. Further studies supporting these results could reveal the first real treatment option for PXE.
文摘A 43-year-old man with pancytopenia from chemotherapy for acute myeloid leukemia developed left scrotal pain, fever, and rigors. Physical exam revealed an ulcerating lesion with central necrosis and eschar surrounded by a halo of erythema on the inferior aspect of the left scrotum. The condition indicated an early necrofizing soft tissue infection. The patient was started on broad-spectrum antibiotics and taken to the operating room for a wound debridement. Blood and tissue cultures grew Pseudomonas aeruginosa, which confirmed the diagnosis of ecthyma gangrenosum of the scrotum. The fever resolved, and the wound healed without further progression after wet to dry dressing changes.
