Giant cell arteritis (GCA) is a large vessel vasculitis with cranial and extracranial vessel involvement. Clinicians suspect GCA when a patient exhibits symptoms or exam findings of temporal headache with sudden vision loss, jaw or tongue claudication, scalp tenderness, abnormal temporal artery exam, and diagnostic findings, including elevated inflammatory markers. We present a case, which highlights that, despite established diagnostic measures, challenges persist.
View Article and Find Full Text PDFGuidelines recommend intravenous loop diuretics as first-line therapy for patients hospitalized with acute heart failure (AHF) and volume overload. Additional agents can be used for augmentation, but there is limited guidance on agent selection. The study objective was to determine if chlorothiazide or metolazone is associated with differences in diuretic efficacy or safety in loop diuretic-resistant patients with AHF and renal dysfunction (eGFR <45 mL/min/1.
View Article and Find Full Text PDFThe conventional dose of 10 units of intravenous (IV) regular insulin to treat hyperkalemia has been associated with hypoglycemia. There have been retrospective studies evaluating weight-based dose vs conventional dose of IV regular insulin but the comparative efficacy and safety is not well established. : Evaluate the difference in weight-based dosing of IV regular insulin between patients who experienced hypoglycemia vs.
View Article and Find Full Text PDFBackground: Fibroblast apoptosis is a critical component of normal repair and the acquisition of an apoptosis-resistant phenotype contributes to the pathogenesis of fibrotic repair. Fibroblasts from fibrotic lungs of humans and mice demonstrate resistance to apoptosis induced by Fas-ligand and prior studies have shown that susceptibility to apoptosis is enhanced when Fas (CD95) expression is increased in these cells. Moreover, prior work shows that Fas expression in fibrotic lung fibroblasts is reduced by epigenetic silencing of the Fas promoter.
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