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  1. Article: Acute Esophageal Necrosis (Gurvits Syndrome): A Rare Complication of Diabetic Ketoacidosis in a Critically Ill Patient.

    Vien, Linda P / Yeung, Ho-Man

    Case reports in medicine

    2020  Volume 2020, Page(s) 5795847

    Abstract: Acute esophageal necrosis (AEN) is a rare clinical diagnosis that primarily affects the distal third of the esophagus. AEN causes odynophagia, leading to decreased oral intake and food avoidance. AEN can arise in critically ill patients with multiple ... ...

    Abstract Acute esophageal necrosis (AEN) is a rare clinical diagnosis that primarily affects the distal third of the esophagus. AEN causes odynophagia, leading to decreased oral intake and food avoidance. AEN can arise in critically ill patients with multiple comorbidities and is an uncommon complication of diabetic ketoacidosis (DKA). We present a case of a young female with poorly controlled, insulin-dependent diabetes mellitus type 2 who developed odynophagia, small volume coffee-ground emesis, and inability to tolerate oral intake after resolution of DKA. She was found to have esophagitis with esophageal necrosis in the middle third of the esophagus on upper gastrointestinal endoscopy. She was subsequently treated with fluid resuscitation and gastric acid suppression and improved clinically with slow advancements in her diet. The location of her lesion in the more vascularized middle one-third of the esophagus and lack of significant blood pressure variations during her hospital stay make her case unique. Thus, AEN should be considered in the differential diagnosis for critically ill patients who present with vague symptoms such as odynophagia and gastrointestinal bleeding.
    Language English
    Publishing date 2020-02-27
    Publishing country United States
    Document type Case Reports
    ZDB-ID 2502642-2
    ISSN 1687-9635 ; 1687-9627
    ISSN (online) 1687-9635
    ISSN 1687-9627
    DOI 10.1155/2020/5795847
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: Primary extranodal jejunal diffuse large B cell lymphoma as a diagnostic challenge for intractable emesis: a case report and review of literature.

    Vien, Linda P / Bains, Ashish / Yeung, Ho-Man

    Journal of community hospital internal medicine perspectives

    2019  Volume 9, Issue 6, Page(s) 518–523

    Abstract: ... ...

    Abstract Introduction
    Language English
    Publishing date 2019-12-14
    Publishing country United States
    Document type Case Reports
    ZDB-ID 2616884-4
    ISSN 2000-9666
    ISSN 2000-9666
    DOI 10.1080/20009666.2019.1687115
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article: Interstitial Emphysema as a Rare Radiographic Presentation of Bronchial Dehiscence after Lung Transplant.

    Vien, Linda P / Marron, Robert M / Charlie, Abbas / Kumaran, Maruti / Brown, James C

    Case reports in pulmonology

    2020  Volume 2020, Page(s) 8830361

    Abstract: Airway complications after lung transplantation are a major cause of morbidity and mortality. Bronchial dehiscence presents within a month of lung transplantation and is typically diagnosed radiographically as a sentinel gas pocket at the anastomotic ... ...

    Abstract Airway complications after lung transplantation are a major cause of morbidity and mortality. Bronchial dehiscence presents within a month of lung transplantation and is typically diagnosed radiographically as a sentinel gas pocket at the anastomotic site and confirmed with bronchoscopy. A 66-year-old man with idiopathic pulmonary fibrosis who underwent a right lung transplantation 4 weeks prior developed chest pain with palpable crepitus over his right chest wall. A chest X-ray revealed subcutaneous emphysema and a small right-sided pneumothorax. Computed tomography (CT) of the thorax without contrast revealed a gas pocket at the anastomotic site in the mediastinum as well as interstitial emphysema around the proximal bronchi of the right lung that had worsened when compared to CT from 11 days prior. A review of prior CT demonstrated interstitial emphysema without evidence of a sentinel gas pocket. These findings suggest that interstitial emphysema was the initial radiographic manifestation of the bronchial anastomotic site dehiscence. Interstitial emphysema is typically self-limiting, but severe cases can lead to major complications. Interstitial emphysema outside of the immediate postoperative period should be recognized as a possible early radiographic sign of bronchial dehiscence in lung transplant patients with vigilant monitoring of potential complications and strong consideration for early bronchoscopic investigation.
    Language English
    Publishing date 2020-12-26
    Publishing country United States
    Document type Case Reports
    ZDB-ID 2666707-1
    ISSN 2090-6854 ; 2090-6846
    ISSN (online) 2090-6854
    ISSN 2090-6846
    DOI 10.1155/2020/8830361
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: The importance of quality of life in patients with alcohol abuse and dependence.

    Ugochukwu, Chio / Bagot, Kara Simone / Delaloye, Sibylle / Pi, Sarah / Vien, Linda / Garvey, Tim / Bolotaulo, Nestor Ian / Kumar, Nishant / Ishak, Waguih William

    Harvard review of psychiatry

    2013  Volume 21, Issue 1, Page(s) 1–17

    Abstract: Learning objectives: After participating in this educational activity, the reader should be better able to identify the instruments that are currently being used to measure quality of life (QoL) in alcohol abuse and dependence; determine the impact of ... ...

    Abstract Learning objectives: After participating in this educational activity, the reader should be better able to identify the instruments that are currently being used to measure quality of life (QoL) in alcohol abuse and dependence; determine the impact of alcohol abuse and dependence on QoL; and evaluate the impact of treating alcohol abuse and dependence on QoL.
    Objective: Quality of life, which consists of the physical, mental, and social domains, has been shown to be negatively affected by alcohol abuse and dependence. This review aims to examine QoL in alcohol abuse and dependence by reviewing the instruments used to measure it and by analyzing the impact of alcohol abuse and dependence and of treatment on QoL.
    Methods: Studies were identified using a database search of PubMed and PsycINFO from the past 40 years (1971-2011) using the following keywords: abuse OR dependence, OR use AND alcohol, AND Quality of Life, QoL, Health-related quality of life, HRQOL. Two authors agreed independently on including 50 studies that met specific selection criteria.
    Results: Although several global measures of QoL have established reliability and validity, many alcohol-specific measures of QoL have not yet been validated. Nevertheless, QoL has been shown to be significantly impaired in those with alcohol abuse and dependence, particularly in the domains of mental health and social functioning, the very areas that show the greatest improvement with abstinence and its maintenance. Moreover, the literature demonstrates the utility of using QoL measures throughout assessment and treatment as a motivational tool and as a marker for treatment efficacy.
    Conclusions: Measuring and monitoring QoL during assessment and treatment can add important value to patient recovery, for QoL improves with treatment and successful abstinence. Therefore, targeted, disease-specific assessments of QoL are warranted to address the impairments in the physical, mental, and social domains in alcohol abuse and dependence, thereby improving long-term outcomes.
    MeSH term(s) Alcoholism/prevention & control ; Alcoholism/psychology ; Attitude to Health ; Child ; Clinical Trials as Topic ; Female ; Health Status ; Humans ; Interpersonal Relations ; Personal Satisfaction ; Quality of Life/psychology ; Reproducibility of Results ; Self Efficacy ; Surveys and Questionnaires
    Language English
    Publishing date 2013-05-08
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 1174775-4
    ISSN 1465-7309 ; 1067-3229
    ISSN (online) 1465-7309
    ISSN 1067-3229
    DOI 10.1097/HRP.0b013e31827fd8aa
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Cyclization of fungal nonribosomal peptides by a terminal condensation-like domain.

    Gao, Xue / Haynes, Stuart W / Ames, Brian D / Wang, Peng / Vien, Linda P / Walsh, Christopher T / Tang, Yi

    Nature chemical biology

    2012  Volume 8, Issue 10, Page(s) 823–830

    Abstract: Cyclization of linear peptidyl precursors produced by nonribosomal peptide synthetases (NRPSs) is an important step in the biosynthesis of bioactive cyclic peptides. Whereas bacterial NRPSs use thioesterase domains to perform the cyclization, fungal ... ...

    Abstract Cyclization of linear peptidyl precursors produced by nonribosomal peptide synthetases (NRPSs) is an important step in the biosynthesis of bioactive cyclic peptides. Whereas bacterial NRPSs use thioesterase domains to perform the cyclization, fungal NRPSs have apparently evolved to use a different enzymatic route. In verified fungal NRPSs that produce macrocyclic peptides, each megasynthetase terminates with a condensation-like (C(T)) domain that may perform the macrocyclization reaction. To probe the role of such a C(T) domain, we reconstituted the activities of the Penicillium aethiopicum trimodular NPRS TqaA in Saccharomyces cerevisiae and in vitro. Together with the reconstituted bimodular NRPS AnaPS, we dissected the cyclization steps of TqaA in transforming the linear anthranilate-D-tryptophan-L-alanyl tripeptide into fumiquinazoline F. Extensive biochemical and mutational studies confirmed the essential role of the C(T) domain in catalyzing cyclization in a thiolation domain-dependent fashion. Our work provides evidence of a likely universal macrocyclization strategy used by fungal NRPSs.
    MeSH term(s) Amino Acid Sequence ; Chromatography, Affinity ; Cyclization ; Fungal Proteins/chemistry ; Fungal Proteins/isolation & purification ; Penicillium/chemistry ; Protein Structure, Tertiary ; Ribosomal Proteins/chemistry
    Chemical Substances Fungal Proteins ; Ribosomal Proteins
    Language English
    Publishing date 2012-08-16
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural
    ZDB-ID 2202962-X
    ISSN 1552-4469 ; 1552-4450
    ISSN (online) 1552-4469
    ISSN 1552-4450
    DOI 10.1038/nchembio.1047
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Utility of a Clinical Scoring System for Point of Care Triaging in COVID-19 Pneumonia

    Gangemi, Andrew J / Gupta, Rohit / Fernandez-Romero, Gustavo / Zhao, Huaqing / Patel, Maulin / Chowdhury, Junad / Zantah, Massa / Zheng, Matthew / Abramian, Osheen / Codella, Stephen / Vien, Linda / Dominguez-Castillo, Eduardo / Buckey, Timothy / Earley, Charles / Frankovich, Jourdan / Jurkowski, Mali / Jurkowski, Zachary / O'Brien, Jenny / Guo, Nanzhou /
    Stanley, Paige / Halsey, Brenton / Kahlon, Jasleen / Kaur, Navjot / Prosniak, Roman / Kumaran, Maruti / Dass, Chandra / Fleece, David / Jacobs, Michael R / Criner, Gerard J / Temple University COVID-19 Research Group

    medRxiv

    Abstract: Background: Surges in COVID-19 disease cases can rapidly overwhelm healthcare resources; triaging to appropriate levels of care can assist in resource planning. At the beginning of the pandemic, we developed a simple triage tool, the Temple COVID-19 ... ...

    Abstract Background: Surges in COVID-19 disease cases can rapidly overwhelm healthcare resources; triaging to appropriate levels of care can assist in resource planning. At the beginning of the pandemic, we developed a simple triage tool, the Temple COVID-19 Pneumonia Triage Tool (TemCOV) based on a combination of clinical and radiographic features that are readily available on presentation to categorize and predict illness severity. Methods: We prospectively examined 579 sequential cases admitted to Temple University Hospital who were assigned severity categories on admission. Our primary outcome was to compare the performance of TemCOV in predicting patients who have the highest likely of admission to the ICU at 24 and at 72 hours to other standard triage tools: the National Early Warning System (NEWS), the Modified Early Warning System (MEWS) and the CURB65 score. Additional endpoints included need for invasive mechanical ventilation (IMV) within 72 hours, total hospital admission charges, and mortality. Results: 26% of patients fell within our highest risk Category 4 and were more likely to require ICU admission at 24 hours (OR 11.51) and 72 hours (OR 8.6). Additionally they had the highest likelihood of needing IMV (OR 29.47) and in-hospital mortality (OR 2.37). , TemCOV performed similar to MEWS in predicting ICU admission at 24 hours (receive operator characteristic (ROC) curve area under the curve (AUC) 0.77 vs. 0.74, p=0.21) but better than NEWS2 and CURB65 (ROC AUC 0.77 vs. 0.69 and 0.77 vs. 0.64, respectively, p<0.01). While all severity scores had a weak correlation to hospital charges, the TemCOV performed the best among all severity scores measured (r=0.18); median hospital charges for Category 4 patients was $170,468 ($96,972-$487,556). Conclusion: TemCOV is a simple triage score that can be used upon hospitalization in patients with COVID-19 that predicts the need for hospital resources such as ICU bed capacity, invasive mechanical ventilation and personnel staffing.
    Keywords covid19
    Language English
    Publishing date 2021-03-02
    Publisher Cold Spring Harbor Laboratory Press
    Document type Article ; Online
    DOI 10.1101/2021.02.26.21252256
    Database COVID19

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