RESUMEN
Psoriasis is a chronic skin disorder, and patients encounter high physical and psychosocial burdens. Social media forums feature extensive patient-generated comments. We hypothesized that analyzing patient-posted comments using natural language processing would provide insights into patient engagements, sentiments, concerns, and support, which are vital for the holistic management of psoriasis. We collected 32,000 active user comments posted on Reddit. We applied Latent Dirichlet Allocation to categorize posts into popular topics and employed spectral clustering to establish cohesive themes and word representation frequency within these topics. We sorted posts into 29 significant topics of discussion and categorized them into four categories: management (37.48%), emotion (21.57%), presentation (19.79%), and others (3.57%). The frequent posts on management were diet (7.23%), biologics (6.95%), and adverse effects (3.88%). The emotion category comprised negative sentiments (11.02%), encouragement (5.49%), and gratitude (5.06%). The presentation topic included a discussion of scalp (5.69%), flare-timing (3.63%), and arthritis (2.64%). Others comprised differential diagnosis (5.01%), leaky gut (4.12%), and referrals (3.70%). This study identified patients' experiences and perspectives associated with psoriasis, which should be considered to tailor support systems to improve their quality of life.
RESUMEN
Esophageal cancer is typically identified as squamous cell carcinoma or adenocarcinoma. There are multiple risk factors that may contribute to esophageal squamous cell carcinoma including smoking, alcohol consumption, and the human papillomavirus. Lesions may appear ulcerated, friable, and circumferential and may obstruct the esophagus. Therefore, patients may complain of non-specific symptoms including dysphagia, weight loss, and retrosternal discomfort. Clinicians often rely on an upper endoscopy with biopsy to confirm the diagnosis. Computed tomography scans and endoscopic ultrasounds are also employed to assess the extent of malignant spread. Management may involve endoscopic resection for superficial lesions or surgical resection for lesions penetrating the submucosa. Esophageal stents may play a role, specifically as a palliative measure for enhancing oral intake. We present an instance of utilizing a self-expandable, metal-covered esophageal stent with balloon dilation in the setting of a newly diagnosed esophageal squamous cell carcinoma lesion in a 73-year-old female. Ultimately, the use of an esophageal stent in this patient helped improve the patient's oral intake during her course of hospitalization. Her diet was slowly advanced to clear liquids and progressively to a low-residue diet before being discharged to follow-up with her diagnosis as outpatient with gastroenterology.
RESUMEN
Lysophosphatidylcholine (LPC) is a bioactive lipid constituent of oxidized low density lipoprotein (ox-LDL). It regulates various cellular functions, including migration of circulating monocytes, expression of endothelial adhesion molecules, proliferation and migration of vascular smooth muscle cells (VSMCs). LPC can also be hydrolyzed into lysophosphatidic acid (LPA) by autotaxin (ATX) which possesses lysophospholipase D (lyso-PLD) activity. The aim of this study was to explore the effects of LPC on proliferation and migration of human artery smooth muscle cells (HASMCs) and the involvement of LPC-ATX-LPA pathway in these processes. In vitro, we found that LPC and LPA stimulated HASMCs proliferation and migration. Knockdown of LPA1 by siRNA and inhibit Gi protein with pertussis toxin (PTX) showed the contrary results. Silencing of LPC receptor genes did not significantly affect the LPC induced proliferation and migration. We detected the higher expressed mRNA and protein of ATX in HASMCs, and measured lyso-PLD activity. In atherosclerotic rabbit model, we observed high LPC level and high lyso-D activity in blood, and high expression of LPA1 in aorta walls. We also found that neointima appeared to be thickened and mRNA expressions of LPA1 appeared to be increased. These results revealed that LPC was converted into LPA by ATX to induce the proliferation and migration in HASMCs through LPA1/Gi/o/MAP Kinase signaling pathway. Our research suggested that LPC-ATX-LPA system contributed to the atherogenic action induced by ox-LDL. LPA1 antagonist may be considered as a potential therapeutic and preventative drug for cardiovascular disease.