Acute myocardial infarction(MI)remains one of the leading causes of mortality and morbidity in the global communities.A prevailing topic that has attracted increasing attentions over the past few decades is the so-cal...Acute myocardial infarction(MI)remains one of the leading causes of mortality and morbidity in the global communities.A prevailing topic that has attracted increasing attentions over the past few decades is the so-called heart-brain interaction,in particular following a major traumatic event such as MI.Increased prevalence of depression and other mental disorders has been recognized in cardiac patients after MI,coronary catheterization,or cardiothoracic surgeries.In this review,we focus on the potential pathogenic mechanisms and pre-clinical transcriptomic evidence for identifying potential mediators of post-MI depression.We first summarize the conventional mechanistic understanding that leads to the current clinical management of post-MI depression with the use of selective serotonin reuptake inhibitors(SSRIs)and cognitive behavior and exercise therapies.We further envisage a possible role played by certain chemokines,e.g.,Chemokine(C-X-C motif)ligand 12(CXCL12)and Chemokine(C-C motif)ligand 2(CCL22),in serving as signaling molecules to connect the MI-induced heart damage to the pro-depressive changes in brain during the post-MI period.Future in-depth investigations into this chemokine hypothesis will be instrumental in developing new chemokine-targeted therapies for better management of the cardiac patients suffering from post-MI depression.展开更多
BACKGROUND Screening colonoscopies are routinely performed and have low occurrences of adverse events such as perforation,bleeding,infection,and post-polypectomy syndrome.True device related adverse events are rarely ...BACKGROUND Screening colonoscopies are routinely performed and have low occurrences of adverse events such as perforation,bleeding,infection,and post-polypectomy syndrome.True device related adverse events are rarely reported in the literature.CASE SUMMARY We report a case of a 51-year-old patient without past medical history who presented for her first screening colonoscopy.The patient was thought to have friable mucosa in the cecum and oozed upon water irrigation during screening colonoscopy.It was later identified that the colonoscope used during the index procedure had malfunctioned and produced a pin-point water jet which damaged the colon mucosa of cecum.The maintenance service identified a piece of rubber fragment lodged in the instrument component at the tip of the scope,resulting in high pressure water jet.Repeat colonoscopy with a functioning colonoscope confirmed normal colon mucosa without friability.CONCLUSION This is the first report of mucosa injury from a colonoscope water jet malfunction.Endoscopists should recognize the potential for endoscopic malfunction.展开更多
文摘Acute myocardial infarction(MI)remains one of the leading causes of mortality and morbidity in the global communities.A prevailing topic that has attracted increasing attentions over the past few decades is the so-called heart-brain interaction,in particular following a major traumatic event such as MI.Increased prevalence of depression and other mental disorders has been recognized in cardiac patients after MI,coronary catheterization,or cardiothoracic surgeries.In this review,we focus on the potential pathogenic mechanisms and pre-clinical transcriptomic evidence for identifying potential mediators of post-MI depression.We first summarize the conventional mechanistic understanding that leads to the current clinical management of post-MI depression with the use of selective serotonin reuptake inhibitors(SSRIs)and cognitive behavior and exercise therapies.We further envisage a possible role played by certain chemokines,e.g.,Chemokine(C-X-C motif)ligand 12(CXCL12)and Chemokine(C-C motif)ligand 2(CCL22),in serving as signaling molecules to connect the MI-induced heart damage to the pro-depressive changes in brain during the post-MI period.Future in-depth investigations into this chemokine hypothesis will be instrumental in developing new chemokine-targeted therapies for better management of the cardiac patients suffering from post-MI depression.
文摘BACKGROUND Screening colonoscopies are routinely performed and have low occurrences of adverse events such as perforation,bleeding,infection,and post-polypectomy syndrome.True device related adverse events are rarely reported in the literature.CASE SUMMARY We report a case of a 51-year-old patient without past medical history who presented for her first screening colonoscopy.The patient was thought to have friable mucosa in the cecum and oozed upon water irrigation during screening colonoscopy.It was later identified that the colonoscope used during the index procedure had malfunctioned and produced a pin-point water jet which damaged the colon mucosa of cecum.The maintenance service identified a piece of rubber fragment lodged in the instrument component at the tip of the scope,resulting in high pressure water jet.Repeat colonoscopy with a functioning colonoscope confirmed normal colon mucosa without friability.CONCLUSION This is the first report of mucosa injury from a colonoscope water jet malfunction.Endoscopists should recognize the potential for endoscopic malfunction.
