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She had been administered COVID-19 vaccination in the left deltoid 1 week earlier and required hospitalization for 24 hours due to fever. Symptoms settled with supportive treatment. One month after the PET/CT scan, she remained well. Sites of uptake were taken to relate to a systemic immune response.

Ankylosing spondylitis represents an inflammatory arthropathy with a predilection for the axial skeleton. We reported 68Ga-FAPI PET/CT finding of ankylosing spondylitis in a 65-year-old patient with rectal cancer. In addition to accumulating in primary tumor and metastatic lymph nodes, increased 68Ga-FAPI uptake was also observed in the sacroiliac and costovertebral joints, indicating sacroiliitis and spondylitis. However, no abnormal 18F-FDG uptake was observed in the inflammatory lesions. This case highlighted that 68Ga-FAPI PET/CT is useful for the evaluation of inflammatory conditions in ankylosing spondylitis.

Ankylosing spondylitis represents an inflammatory arthropathy with a predilection for the axial skeleton. We reported 68Ga-FAPI PET/CT finding of ankylosing spondylitis in a 65-year-old patient with rectal cancer. In addition to accumulating in primary tumor and metastatic lymph nodes, increased 68Ga-FAPI uptake was also observed in the sacroiliac and costovertebral joints, indicating sacroiliitis and spondylitis. However, no abnormal 18F-FDG uptake was observed in the inflammatory lesions. This case highlighted that 68Ga-FAPI PET/CT is useful for the evaluation of inflammatory conditions in ankylosing spondylitis.

The endothelial glycocalyx, a carbohydrate-rich layer coating all endothelial surfaces, plays a fundamental role in the function of microcirculation. The primary aim of this study was to evaluate the feasibility of using dexamethasone and albumin to protect the endothelial glycocalyx in patients undergoing abdominal surgery. Secondary and exploratory outcomes included efficacy and safety.

We conducted a multicenter, open-label, blinded end point, phase 2, randomized trial. Patients undergoing colorectal, pancreas, or liver surgery were recruited and randomized to receive either intravenous dexamethasone (16 mg) and 20% albumin (100 mL) at induction of anesthesia, then 200 mL of 20% albumin with each subsequent 1000 mL of crystalloid administered (dexamethasone and albumin [Dex-Alb] group), or crystalloid fluid only with no dexamethasone (control group). Feasibility end points included patient recruitment and retention, consent rate, and successful study drug administration. The primary efficacy end point utcomes is warranted.

Stroke has been reported in observational series as a frequent complication of coronavirus disease 2019, but more information is needed regarding stroke prevalence and outcomes. We explored the prevalence and outcomes of acute stroke in an international cohort of patients with coronavirus disease 2019 who required ICU admission.

Retrospective analysis of prospectively collected database.

A registry of coronavirus disease 2019 patients admitted to ICUs at over 370 international sites was reviewed for patients diagnosed with acute stroke during their stay.

Patients older than 18 years old with acute coronavirus disease 2019 infection in ICU.

None.

Of 2,699 patients identified (median age 59 yr; male 65%), 59 (2.2%) experienced acute stroke 0.7% ischemic, 1.0% hemorrhagic, and 0.5% unspecified type. Systemic anticoagulant use was not associated with any stroke type. The frequency of diabetes, hypertension, and smoking was higher in patients with ischemic stroke than in stroke-free and hemorrhagic strs with coronavirus disease 2019, stroke was infrequent. Hemorrhagic stroke, but not ischemic stroke, was associated with increased mortality. Further, both hemorrhagic stroke and ischemic stroke were associated with traditional vascular risk factors. Extracorporeal membrane oxygenation use was strongly associated with both stroke and death.

We sought to compare overall survival (OS) and disease control for patients with localized pancreatic adenocarcinoma (PDAC) treated with ablative dose radiotherapy (A-RT) vs. resection.

Locoregional treatment for PDAC includes resection when possible or palliative RT. A-RT may offer durable tumor control and encouraging survival.

This was a single-institution retrospective analysis of patients with PDAC treated with induction chemotherapy followed by A-RT (≥ 98Gy biologically effective dose (BED) using 15-25 fractions in 3-4.5 Gy/fraction) or pancreatectomy.

One hundred and four patients received A-RT (49.8%) and 105 (50.2%) underwent resection. Patients receiving A-RT had larger median tumor size after induction chemotherapy [3.2 cm (undetectable-10.9) vs. 2.6 cm (undetectable-10.7), P < 0.001], and were more likely to have celiac or hepatic artery encasement (48.1% vs. 11.4%, P < 0.001), or superior mesenteric artery encasement (43.3% vs. 9.5%, P < 0.001); however, there was no difference in the degree of SMV/PV involvement (P = 0.123). There was no difference in locoregional recurrence/progression at 18-months between A-RT and resection; cumulative incidence was 16% (95% CI 10%-24%) vs. 21% (95% CI 14%-30%), respectively (P= 0.252). However, patients receiving A-RT had a 19% higher 18-month cumulative incidence of distant recurrence/progression (58% [95% CI 48%-67%] vs. 30% [95% CI 30%-49%], P= 0.004). Median OS from completion of chemotherapy was 20.1 months for A-RT patients (95% C.I. ABT-199 16.4-23.1 mo.) vs. 32.9 months (95% C.I. 29.7-42.3 mo.) for resected patients (P < 0.001).

Ablative radiation is a promising new treatment option for PDAC, offering locoregional disease control similar to that associated with resection and encouraging survival.

Ablative radiation is a promising new treatment option for PDAC, offering locoregional disease control similar to that associated with resection and encouraging survival.

Our goal is to review pertinent data evaluating the association between immune checkpoint inhibitor (ICI)-induced endocrine dysfunction and survival in cancer patients as well as to understand the potential molecular links between these.

ICIs have revolutionized cancer therapy but have also led to multiple immune-related adverse events (irAEs). Studies have demonstrated a link between the development of irAEs and improved survival, suggesting that ICI-induced antitumor immunity and autoimmunity are coupled. Thyroid irAEs are most frequently and strongly associated with improved survival, particularly in the context of overt thyroid dysfunction. Other endocrine irAEs, such as hypophysitis and diabetes are quite rare wherein the treatment approach or the disease process itself may mitigate improvement in survival. Preclinical and translational data indicate a role for CD4+ T cells, regulatory T cells and/or cytokines mediating irAEs, including thyroiditis.

The development of irAEs is associated with impro durable antitumor response to ICIs. Although irAEs and antitumor immunity appear 'coupled', translational studies indicate the potential for their 'uncoupling', which could enable antitumor efficacy with greater safety margins.

The Duke Healthy Lifestyles Program (HL), established in 2006, has treated over 15,000 pediatric patients with obesity. A subset of patients with obesity do not respond to dietary and lifestyle changes. Development of the Staged Transitional Eating Plan (STEP) in 2012 provided a ketogenic advanced dietary option for these specific patients.

The goal of STEP is to facilitate weight loss, while assuring adequacy and the promotion of health through the abundant inclusion of vegetables, fatty fish, nuts, olive oil, and other foods consistent with the Mediterranean Diet. STEP is a three-phase eating plan, each with a defined carbohydrate limit. STEP is ideal for patients eager to try a low carbohydrate diet, those with good vegetable acceptance, and those with families who are able to participate in the same eating plan as them.

STEP, the HL version of low carbohydrate high fat eating, is a safe dietary intervention for a carefully selected subset of pediatric patients with obesity who are trying to lose weight.

STEP, the HL version of low carbohydrate high fat eating, is a safe dietary intervention for a carefully selected subset of pediatric patients with obesity who are trying to lose weight.

To highlight the benefits of a partnership between patient advocacy organizations (PAO) and clinical researchers in order to clinically study the prior anecdotal patient experience of utilizing a low-carbohydrate ketogenic diet (LCKD) to manage McArdle disease.

The bedside-to-bench and back again method of translational research is well suited to explore anecdotal patient experiences, particularly for rare diseases. In McArdle disease, patients have explored the use of a LCKD to address the ubiquitous occurrence of physical activity intolerance and minimize associated adverse events. The International Association for Muscle Glycogen Storage Disease harnessed the power of social media to better understand this patient-centric finding and has subsequently partnered with clinical researchers to convey patient-centered priorities for research. From this partnership, a series of clinical and survey studies have been initiated.

Collaboration between PAOs and clinical researchers has the potential to foster patient empowerment, advance anecdotal experiences into scientific hypotheses, and ultimately guide the development of management guidelines that reflect the patient perspective.

Collaboration between PAOs and clinical researchers has the potential to foster patient empowerment, advance anecdotal experiences into scientific hypotheses, and ultimately guide the development of management guidelines that reflect the patient perspective.

To summarize emerging connections between sleep, ketogenic diets, and health.

Mechanisms involved in the therapeutic benefits of ketogenic diets continue to be elucidated. Concurrently, the importance of sleep quality and circadian rhythms in their effects on metabolic and cognitive health is increasingly appreciated. Advances in the understanding of the actions of adenosine, nicotinamide adenine dinucleotide, and slow-wave sleep underscore connections between these areas of research.

Many molecular pathways activated during ketogenic diets are known to modulate sleep-wake cycles, circadian rhythms, and sleep stages. Ketogenic diets often have beneficial effects on sleep at the same time as having beneficial effects on particular medical conditions. Enhancement of slow-wave sleep and rejuvenation of circadian programming may be synergistic with or causally involved in the benefits of ketogenic diets.

Many molecular pathways activated during ketogenic diets are known to modulate sleep-wake cycles, circadian rhythms, and sleep stages. Ketogenic diets often have beneficial effects on sleep at the same time as having beneficial effects on particular medical conditions. Enhancement of slow-wave sleep and rejuvenation of circadian programming may be synergistic with or causally involved in the benefits of ketogenic diets.Herpes simplex is a cause of infectious esophagitis. Cirrhosis is the common cause of gastroesophageal varices. But concomitant occurrence of both is not common. In this report, we present a 70-year-old woman with cirrhosis and esophageal varices who was found to have herpes esophagitis concomitantly. The patient was admitted with coffee ground vomiting and ascitis. An esophagogastroduodenoscopy revealed two discrete varices with multiple punched erythematous papules on upper esophagus varices, showing the probability of viral esophagitis. Pathological assessments confirmed herpes esophagitis.

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