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The article presents case study of a 68-year-old woman who was diagnosed with Indian tick typhus caused by Rickettsia conorii subspecies indica. It mentions that Rickettsia conorii subspecies indica was associated with diarrhea, altered mental status, hyponatremia, arthralgias without arthritis, and a mild cough with normal findings on a cardiopulmonary examination and chest radiography.

The article describes the case of a 43-year-old pregnant woman who was admitted to the labor and delivery service of a hospital due to vaginal bleeding. Her medical history included obesity and migraine headaches. During cesarean delivery, the patient experienced suddent onset of bradycardia, chest pain, loss of consciousness and apnea. She was diagnosed with amniotic-fluid embolism. Treatment options for her condition are mechanical circulatory support and extracorporeal membrane oxygenation.

The article describes the case of a 55-year-old man who experienced alcohol withdrawal delirium and multifactorial delirium. The patient was admitted to the intensive care unit (ICU) at the Massachusetts General Hospital because of seizures and agitation. He was found to be confused and afebrile after he stopped drinking alcohol. Signs and symptoms of alcohol withdrawal delirium include hallucinations, hypertension, tachycardia, fever and diaphoresis.

Background: Enzalutamide (formerly called MDV3100) targets multiple steps in the androgen-receptor–signaling pathway, the major driver of prostate-cancer growth. We aimed to evaluate whether enzalutamide prolongs survival in men with castration-resistant prostate cancer after chemotherapy. Methods: In our phase 3, double-blind, placebo-controlled trial, we stratified 1199 men with castration-resistant prostate cancer after chemotherapy according to the Eastern Cooperative Oncology Group performance-status score and pain intensity. We randomly assigned them, in a 2:1 ratio, to receive oral enzalutamide at a dose of 160 mg per day (800 patients) or placebo (399 patients). The primary end point was overall survival. Results: The study was stopped after a planned interim analysis at the time of 520 deaths. The median overall survival was 18.4 months (95% confidence interval [CI], 17.3 to not yet reached) in the enzalutamide group versus 13.6 months (95% CI, 11.3 to 15.8) in the placebo group (hazard ratio for death in the enzalutamide group, 0.63; 95% CI, 0.53 to 0.75; P<0.001). The superiority of enzalutamide over placebo was shown with respect to all secondary end points: the proportion of patients with a reduction in the prostate-specific antigen (PSA) level by 50% or more (54% vs. 2%, P<0.001), the soft-tissue response rate (29% vs. 4%, P<0.001), the quality-of-life response rate (43% vs. 18%, P<0.001), the time to PSA progression (8.3 vs. 3.0 months; hazard ratio, 0.25; P<0.001), radiographic progression-free survival (8.3 vs. 2.9 months; hazard ratio, 0.40; P<0.001), and the time to the first skeletal-related event (16.7 vs. 13.3 months; hazard ratio, 0.69; P<0.001). Rates of fatigue, diarrhea, and hot flashes were higher in the enzalutamide group. Seizures were reported in five patients (0.6%) receiving enzalutamide. Conclusions: Enzalutamide significantly prolonged the survival of men with metastatic castration-resistant prostate cancer after chemotherapy. (Funded by Medivation and Astellas Pharma Global Development; AFFIRM ClinicalTrials.gov number, NCT00974311.) [ABSTRACT FROM PUBLISHER]

The article discusses the medical case of a 49-year-old man presented with fever, pain and cranial nerve deficits after squamous-cell cancer of the oral cavity treatment. The patient's medical history is detailed. Results of pathological examination on the patient are discussed as well as the differential diagnosis centered on an infectious process and recurrent cancer. Management of squamous-cell carcinoma of the head and neck and the risk of r5ecurrence are discussed.

The article describes the case of a 30-year-old woman presented with shock and abdominal-wall necrosis after a cesarean section. The patient had undergone cesarean section at 36.4 weeks gestation due to suspected chorioamnionitis, fetal tachycardia and a prolonged deceleration on a fetal heart-rate tracing during labor augmented by oxytocin. Her medications on admission included prenatal vitamins, iron and acetaminophen. Details of the results of her laboratory tests are discussed.

The article describes the case of a 60-year-old woman who complained of painful muscle spasms, weakness and hyperreflexia. Information on her medical history is provided, as well as the results of her laboratory tests. Degenerative changes of both the cervical and lumbar spine were detective via magnetic resonance imaging. Differential diagnosis include limbic encephalitis and herpes encephalitis. She was diagnosed with stiff person syndrome and anti-amphiphysin antibodies.

Phospholipase Cβ (PLCβ) enzymes regulate second messenger production following the activation of G protein-coupled receptors (GPCRs). Under basal conditions, these enzymes are maintained in an autoinhibited state by multiple elements, including an insertion within the catalytic domain known as the X–Y linker. Although the PLCβ X–Y linker is variable in sequence and length, its C-terminus is conserved and features an acidic stretch, followed by a short helix. This helix interacts with residues near the active site, acting as a lid to sterically prevent substrate binding. However, deletions that remove the acidic stretch of the X–Y linker increase basal activity to the same extent as deletion of the entire X–Y linker. Thus, the acidic stretch may be the linchpin in autoinhibition mediated by the X–Y linker. We used site-directed mutagenesis and biochemical assays to investigate the importance of this acidic charge in mediating PLCβ3 autoinhibition. Loss of the acidic charge in the X–Y linker increases basal activity and decreases stability, consistent with loss of autoinhibition. However, introduction of compensatory electrostatic mutations on the surface of the PLCβ3 catalytic domain restore activity to basal levels. Thus, intramolecular electrostatics modulate autoinhibition by the X–Y linker. • Monitoring PI hydrolysis is a viable method for measuring in vitro activity of PLC. • PLCβ3 autoinhibition requires a highly negatively charged X–Y linker. • Intramolecular electrostatics within PLCβ3 regulate its stability and activity. [ABSTRACT FROM AUTHOR]