Journal of investigative medicine : the official publication of the American Federation for Clinical Research
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Cirrhosis, an advanced stage of liver diseases, induces Cirrhosis-Associated Immune Dysfunction Syndrome (CAIDS) characterized by both innate and adaptive immune dysfunction. Inflammation triggered by factors such as alcohol, viruses, toxins, and cholesterol induce metabolic reprogramming of both innate and adaptive immune cells. Our study specifically sought to investigate the compromised adaptive immune response in cirrhosis by focusing on assessing T-cell exhaustion and activation markers on helper and cytotoxic T cells. ⋯ The observation of impaired adaptive immunity with notable T cell exhaustion and activation in cirrhosis underscores the potential relevance of immunotherapy.
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EXPRESS: Implementation of telepsychiatry in an urban pediatric satellite emergency department (ED).
While pediatric mental health emergencies are increasing in frequency and severity, psychiatric resources remain concentrated in tertiary care facilities. Telepsychiatry has successfully mitigated these challenges in rural emergency departments (EDs), suggesting potential benefits for urban EDs that lack psychiatric resources. We implemented telepsychiatry in an urban ED to reduce ED length of stay and the need for transferring pediatric patients with mental and behavioral health complaints. ⋯ The median length of stay decreased significantly from 473 minutes (95% CI=431-733) to 275 min (95% CI=316-462) after implementation. Repeat visits for mental health complaints within 30 days decreased from 23% to 10%. Implementing a telepsychiatry evaluation program in an urban pediatric satellite ED reduced transfers and decreased patient length of stay.
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Pancreatic cancer is characterized by occult onset, low early diagnosis rate, rapid progress, and poor prognosis. Due to the low response rate and low programmed cell death ligand 1 (PD-L1) expression in pancreatic cancer, the therapeutic application of PL-L1 inhibitors in pancreatic cancer is greatly limited. In vitro studies showed that the expression of PD-L1 increased in pancreatic cancer cells stimulated by fluorouracil (5-FU). ⋯ Moreover, the combination with the 5-FU remarkably enhanced the immune cytotoxicity of anti-PD-L1 antibodies in mice. In vitro analysis demonstrates that 5-FU increases the expression of PD-L1 on the surface of pancreatic cancer cell lines via up-regulating nuclear factor kappa B (NF-κB) and Protein kinase B (AKT) pathways. This synergistic effect could be abolished by NF-κB and AKT inhibitors.
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This study investigates the combined efficacy of orthokeratology lenses and 0.01% atropine in controlling the progression of pediatric progressive myopia. The study, conducted retrospectively on 33 children aged 8-14, measured key parameters, including axial length growth, uncorrected visual acuity (UCVA), intraocular pressure (IOP), tear film breakup time (TBUT), and pupil diameter. ⋯ TBUT decreased, and pupil diameter increased post-treatment. The findings suggest that combining orthokeratology with low-dose atropine offers a safe and effective strategy for managing pediatric myopia, particularly in younger patients.