BACKGROUND Eltrombopag is an orally administered thrombopoietin receptor agonist linked to a heightened risk of treatment-related thromboembolism.Both venous and arterial thromboses have been documented in the medical...BACKGROUND Eltrombopag is an orally administered thrombopoietin receptor agonist linked to a heightened risk of treatment-related thromboembolism.Both venous and arterial thromboses have been documented in the medical literature.CASE SUMMARY In the absence of nephropathy,a 48-year-old patient receiving eltrombopag for immune thrombocytopenia(ITP)developed renal vein thrombosis and pulmonary embolism.The renal vein thrombus spontaneously resolved during subsequent anticoagulant treatment,restoring venous circulation.CONCLUSION A rapid upsurge in platelets,rather than their absolute number,may trigger thrombotic events in this setting.For patients at high thrombotic risk,individualized eltrombopag dosing and vigilance in platelet monitoring are perhaps needed during treatment of ITP.展开更多
BACKGROUND Gemcitabine is a chemotherapy agent with relatively low toxicities,as a valid option for elderly patients with underlying diseases.Gemcitabine-induced pulmonary toxicities are rare and various,ranging from ...BACKGROUND Gemcitabine is a chemotherapy agent with relatively low toxicities,as a valid option for elderly patients with underlying diseases.Gemcitabine-induced pulmonary toxicities are rare and various,ranging from self-limited episodes of bronchospasm to fatal,progressive,severe,interstitial pneumonitis and respiratory failure.Intravesical gemcitabine instillations are commonly used to reduce recurrence or progression for non-muscle-invasive bladder cancer or urothelial cancer.Few severe toxicities have been reported for the intravesical instillation is assumed to be completely separated from the systemic circulation.CASE SUMMARY A 67-year-old patient received 30 cycles of intravesical gemcitabine instillation after transurethral resection and developed a 1-wk fever,cough,hemoptysis,and dyspnea.After a thorough checkup,bilateral consolidation and infiltration of the lungs were documented and a percutaneous lung biopsy confirmed organizing pneumonia after treatment with broad-spectrum empirical antibiotics failed.Tapered corticosteroids were administered,and pulmonary toxicity gradually resolved.CONCLUSION Gemcitabine-induced pulmonary toxicities present with various manifestations.In spite of the rare pulmonary involvement by the intravesical gemcitabine instillation,health care professionals who administer gemcitabine chemotherapy in this way should monitor for gemcitabine-induced pulmonary toxicities,particularly in patients with high-risk factors.展开更多
As independent financial advisors, securities firms are the core intermediaries in major asset reorganization(MAR) of listed companies.Furthermore, they play the dual roles of transaction and authentication.Based on t...As independent financial advisors, securities firms are the core intermediaries in major asset reorganization(MAR) of listed companies.Furthermore, they play the dual roles of transaction and authentication.Based on this institutional background, this paper studies how listed companies choose between industry experience(‘‘meritocracy') and relationships(‘‘nepotism').Using the MAR of A-share listed companies from 2008 to 2013 as the sample, this paper shows that higher transaction costs(i.e., greater demand for the transaction function of advisors) are related to the higher possibility of advisors with weaker relationships and more industry experience being hired.It also shows that higher suspicion of tunneling(i.e., greater demand for the signal of fairness associated with advisors’ authentication function) is related to the higher possibility of advisors with weaker relationships being hired, but it is not significantly related to whether advisors have more or less industry experience.This paper also shows that reputation has a certain governance effect on the negative consequences of relationship.For the most part, listed companies reward meritocracy but not nepotism when appointing independent financial advisors.展开更多
基金The Natural Science Funding Guidance Project of Liaoning Province,No.2018011494-301345 Talent Program of Shengjing Hospital,China Medical University.
文摘BACKGROUND Eltrombopag is an orally administered thrombopoietin receptor agonist linked to a heightened risk of treatment-related thromboembolism.Both venous and arterial thromboses have been documented in the medical literature.CASE SUMMARY In the absence of nephropathy,a 48-year-old patient receiving eltrombopag for immune thrombocytopenia(ITP)developed renal vein thrombosis and pulmonary embolism.The renal vein thrombus spontaneously resolved during subsequent anticoagulant treatment,restoring venous circulation.CONCLUSION A rapid upsurge in platelets,rather than their absolute number,may trigger thrombotic events in this setting.For patients at high thrombotic risk,individualized eltrombopag dosing and vigilance in platelet monitoring are perhaps needed during treatment of ITP.
文摘BACKGROUND Gemcitabine is a chemotherapy agent with relatively low toxicities,as a valid option for elderly patients with underlying diseases.Gemcitabine-induced pulmonary toxicities are rare and various,ranging from self-limited episodes of bronchospasm to fatal,progressive,severe,interstitial pneumonitis and respiratory failure.Intravesical gemcitabine instillations are commonly used to reduce recurrence or progression for non-muscle-invasive bladder cancer or urothelial cancer.Few severe toxicities have been reported for the intravesical instillation is assumed to be completely separated from the systemic circulation.CASE SUMMARY A 67-year-old patient received 30 cycles of intravesical gemcitabine instillation after transurethral resection and developed a 1-wk fever,cough,hemoptysis,and dyspnea.After a thorough checkup,bilateral consolidation and infiltration of the lungs were documented and a percutaneous lung biopsy confirmed organizing pneumonia after treatment with broad-spectrum empirical antibiotics failed.Tapered corticosteroids were administered,and pulmonary toxicity gradually resolved.CONCLUSION Gemcitabine-induced pulmonary toxicities present with various manifestations.In spite of the rare pulmonary involvement by the intravesical gemcitabine instillation,health care professionals who administer gemcitabine chemotherapy in this way should monitor for gemcitabine-induced pulmonary toxicities,particularly in patients with high-risk factors.
基金the financial support of the National Natural Science Foundation of China (Nos.71802095, 71672204, 71702038)Cen Wu’s China Postdoctoral Science Foundation Grant (No.2018M640888)
文摘As independent financial advisors, securities firms are the core intermediaries in major asset reorganization(MAR) of listed companies.Furthermore, they play the dual roles of transaction and authentication.Based on this institutional background, this paper studies how listed companies choose between industry experience(‘‘meritocracy') and relationships(‘‘nepotism').Using the MAR of A-share listed companies from 2008 to 2013 as the sample, this paper shows that higher transaction costs(i.e., greater demand for the transaction function of advisors) are related to the higher possibility of advisors with weaker relationships and more industry experience being hired.It also shows that higher suspicion of tunneling(i.e., greater demand for the signal of fairness associated with advisors’ authentication function) is related to the higher possibility of advisors with weaker relationships being hired, but it is not significantly related to whether advisors have more or less industry experience.This paper also shows that reputation has a certain governance effect on the negative consequences of relationship.For the most part, listed companies reward meritocracy but not nepotism when appointing independent financial advisors.
