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Bupropion overdose is associated with significant morbidity and mortality due to severe neurologic and cardiovascular toxicity, including seizures and life-threatening arrhythmias. Early recognition of electrocardiographic, clinical, and echocardiographic abnormalities is critical for prompt intervention and prevention of clinical deterioration. We present a case of a 21-year-old female who presented to the emergency department following an intentional polysubstance overdose involving suspected bupropion ingestion. The initial electrocardiogram (EKG) demonstrated sinus tachycardia. However, during continued monitoring, the patient developed QRS widening and seizures. Treatment included benzodiazepines, calcium, and sodium bicarbonate. Point-of-care ultrasound (POCUS) revealed a reduced ejection fraction (EF) of less than 30%, which was later confirmed on formal transthoracic echocardiography. These findings prompted escalation of care, intubation for airway protection and deep sedation, and transfer to the intensive care unit (ICU). During admission, she developed torsades de pointes (TdP), resulting in cardiac arrest. Despite her critical presentation, repeat echocardiography upon

Immunotherapy regimens containing the programmed cell death protein 1 (PD-1) inhibitor pembrolizumab are widely utilised in the management of non-small cell lung cancer (NSCLC). However, the administration of pembrolizumab is associated with unique immune-related adverse events. Adrenal insufficiency is a rare, potentially life-threatening endocrinopathy that can manifest even after the cessation of planned treatment. A male in his 50s with metastatic pulmonary adenocarcinoma developed an acute adrenal crisis 12 days after completing a 24-month course of pembrolizumab immunotherapy. Routine outpatient blood tests first identified critical hypocortisolaemia (morning serum cortisol <50 nmol/L), prompting the patient to attend hospital. The patient subsequently developed severe hypotension (58/45 mmHg) and reported malaise, anorexia, and vomiting after oral intake. Septic shock was considered but felt to be less likely given the absence of infective symptoms. The patient was successfully resuscitated in the emergency department with administration of fluids and high-dose intravenous hydrocortisone. Following clinical stabilisation, under the supervision of the endocrinology team, he w

We’re sharing this article early to provide faster access to peer-reviewed, accepted research. It is citable and carries a permanent DOI. This version is subject to further edits and will be replaced automatically by the final Version of Record. All legal disclaimers apply. AbstractWaterlogged archeological wood (WAW) undergoes lignin oxidation in the presence of air, generating quinones and other conjugated chromophores that cause severe discoloration. As conventional reductants (e.g., Na2S2O4 and NaBH4) struggle to balance between decolorization performance and operational compatibility, a thiourea dioxide (TDO)–amine borane (AB) composite formulation was developed for WAW decolorization. A paper-based solid-phase model with a covalently linked o-quinone motif was constructed for quantitative evaluation. The performances of TDO, dimethylamine borane (DMAB), tert-butylamine borane (TBAB), and their combinations were evaluated on both model and WAW samples. The TDO–AB formulations outperformed single-component treatments in decolorization effect and rate.

Findings may help identify patients who are less likely to respond to neoadjuvant therapy, potentially informing timely consideration of alternative treatment strategies or surgery 68Ga-HER2 PET/CT images before neoadjuvant therapy, at end of second cycle, and before surgery. (A) Baseline scan demonstrated soft-tissue lesion measuring approximately 2.3 × 2.2 cm in upper outer quadrant of left breast, with marked radiotracer uptake and SUVmax of 10.1. (B) At end of second cycle, imaging revealed residual lesion of approximately 2.2 × 1.0 cm in same region, without abnormal radiotracer accumulation. (C) Preoperative imaging demonstrated further reduction in lesion size to approximately 2.0 × 0.6 cm, with no abnormal tracer uptake detected. Image source: adapted from: Gao S, Zhang Z, Cheng C et al, Journal of Nuclear Medicine 2026 (CC BY 4.0)

ORCID: orcid.org/0000-0002-3666-39521, Yuki Hyodo1, Ichiro Kurakazu1, Taisuke Uchida1, Ryota Hirose1, Masanari Kuwahara1, Takumi Kita1, Koki Kato1, Li Ziyang1, Gai Eto1 & … Yasuharu Nakashima1 We’re sharing this article early to provide faster access to peer-reviewed, accepted research. It is citable and carries a permanent DOI. This version is subject to further edits and will be replaced automatically by the final Version of Record. All legal disclaimers apply.