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1Renin angiotensin system in liver diseases: Friend or foe?显示文摘In the last three decades,the understanding of the renin angiotensin system(RAS)has been changed by the discoveries of functional local systems,novel biologically active peptides,additional specific receptors,alternative pathways of angiotensin(Ang)?Ⅱ?generation,and new roles for enzymes and precursor components other than those in Ang?Ⅱ?synthesis.In this regard,the discovery that Ang-(1-7)opposes the pressor,proliferative,pro-fibrotic,and pro-inflammatory effects mediated by Ang?Ⅱ?has contributed to the realization that the RAS is composed of two axes.The first axis consists of the angiotensin-converting enzyme(ACE),with Ang?Ⅱ?as the end product,and the angiotensin type 1(AT1)receptor as the main effector mediating the biological actions of Ang?Ⅱ.The second axis results from ACE2-mediated hydrolysis of Ang?Ⅱ,leading to the production of Ang-(1-7),with the Mas receptor as the main effector conveying the vasodilatory,antiproliferative,anti-fibrotic,and anti-inflammatory effects of Ang-(1-7).Experimental and clinical studies have shown that both axes of the RAS may take part in the pathogenesis of liver diseases.In this manuscript,we summarize the current evidence regarding the role of RAS in hepatic cirrhosis and its complications,including hemodynamic changes and hepatorenal syndrome.The therapeutic potential of the modulation of RAS molecules in liver diseases is also discussed.Ana Cristina Simoes e Silva Aline S Miranda Natália P Rocha Antonio L Teixeira 2017World Journal of Gastroenterology2017,23,19:12
2Concordance of non-invasive mechanical and serum tests for liver fibrosis evaluation in chronic hepatitis C显示文摘AIM To determine the sensitivity and specificity of liver stiffness measurement(LSM) and serum markers(SM) for liver fibrosis evaluation in chronic hepatitis C.METHODS Between 2012 and 2014,81 consecutive hepatitis C virus(HCV) patients had METAVIR score from liver biopsy compared with concurrent results from LSM [transient elastography(TE) [FibroS can~/ARFI technology(Virtual Touch~)] and SM [FIB-4/aspartate aminotransferase-toplatelet ratio index(APRI)].The diagnostic performance of these tests was assessed using receiver operating characteristic curves.The optimal cut-off levels of each test were chosen to define fibrosis stages F ≥ 2,F ≥ 3 and F = 4.The Kappa index set the concordance analysis.RESULTS Fifty point six percent were female and the median age was 51 years(30-78).Fifty-six patients(70%) weretreatment-na?ve.The optimal cut-off values for predicting F ≥ 2 stage fibrosis assessed by TE were 6.6 kP a,for acoustic radiation force impulse(ARFI) 1.22 m/s,for APRI 0.75 and for FIB-4 1.47.For F ≥ 3 TE was 8.9 kP a,ARFI was 1.48 m/s,APRI was 0.75,and FIB-4 was 2.For F = 4,TE was 12.2 kP a,ARFI was 1.77 m/s,APRI was 1.46,and FIB-4 was 3.91.The APRI could not distinguish between F2 and F3,P = 0.92.The negative predictive value for F = 4 for TE and ARFI was 100%.Kappa index values for F ≥ 3 METAVIR score for TE,ARFI and FIB-4 were 0.687,0.606 and 0.654,respectively.This demonstrates strong concordance between all three screening methods,and moderate to strong concordance between them and APRI(Kappa index = 0.507).CONCLUSION Given the costs and accessibility of LSM methods,and the similarity with the outcomes of SM,we suggest that FIB-4 as well as TE and ARFI may be useful indicators of the degree of liver fibrosis.This is of particular importance to developing countries.Denise C Paranaguá-Vezozzo Adriana Andrade Daniel F C Mazo Vinicius Nunes Ana L Guedes Taisa G Ragazzo Renata Moutinho Lucas S Nacif Suzane K Ono Venancio A F Alves Flair J Carrilho 2017World Journal of Hepatology2017,9,8:7
3大气二氧化氮与每日总死亡率、心血管和呼吸系统疾病死亡率的短期关联:398个城市的多中心分析显示文摘目的:采用统一的分析方案,评估全球多个国家/地区的二氧化氮(NO_(2))与总死亡率、心血管和呼吸系统疾病死亡率之间的短期关联。研究设计:采用两阶段的时间序列分析方法、过度离散的广义线性模型和多水平meta分析。研究地点:22个低到高收入国家/地区的398个城市。主要结局指标:1973—2018年逐日总死亡人数(6280万人)、心血管疾病死亡人数(1970万人)和呼吸系统疾病死亡人数(550万人)。结果:平均而言,NO_(2)浓度在滞后1天(前1天)每增加10μg/m^(3),会导致总死亡率、心血管和呼吸系统疾病死亡率分别增加0.46%(95%可信区间0.36%~0.57%)、0.37%(0.22%~0.51%)、0.47%(0.21%~0.72%)。在对共污染物(PM_(10)、PM_(2.5)、臭氧、二氧化硫和一氧化碳)进行调整后,这些关联仍然很稳定。所有3种死因的暴露-反应曲线几乎是线性的,没有明显的阈值。在398个城市中,可归因于高过假定零水平的NO_(2)浓度造成的死亡比例为1.23%(95%可信区间0.96%~1.51%)。结论:这项多中心研究提供了关于NO_(2)短期暴露与总死亡率、心血管和呼吸系统死亡风险之间的独立和线性关联的关键证据,说明通过加强NO_(2)的控制和监管限制标准,可获得人群水平的健康收益。孟夏 刘聪(校) 陈仁杰 郑湃(译) 阚海东(校) Francesco Sera Ana Vicedo-Cabrera Ai Milojevic Maria Guo Yuming Tong Shilu Micheline de Sousa Zanotti Stagliorio Coelh Paulo Hilario Nascimento Saldiva Eric Lavigne Patricia Matus Correa Nicolas Valdes Ortega Samuel Osorio Garcia Jan Kysely Ales Urban Hans Orru Marek Maasikmets Jouni J K Jaakkola Niilo Ryti Veronika Huber Alexandra Schneider Klea Katsouyanni Antonis Analitis Masahiro Hashizume Yasushi Honda Chris Fook Sheng Ng Baltazar Nunes João Paulo Teixeira Iulian Horia Holobaca Simona Fratianni Ho Kim Aurelio Tobias Carmeníniguez Bertil Forsberg ChristoferÅström Martina S Ragettli Yue-Liang Leon Guo Shih-Chun Pan Shanshan Li Michelle L Bell Antonella Zanobetti Joel Schwartz Tangchun Wu Antonio Gasparrini 2021英国医学杂志中文版2021,24,8:7
4hsa-miR-29c and hsa-miR-135b differential expression aspotential biomarker of gastric carcinogenesis显示文摘AIM: To investigate the expression profiles of hsa-mi R-29 c and hsa-mi R-135 b in gastric mucosal samples and their values as gastric carcinogenesis biomarkers. METHODS: The expression levels of hsa-mi R-29 c and hsa-mi R-135 b in normal gastric mucosa, non-atrophic chronic gastritis, intestinal metaplasia and intestinaltype gastric adenocarcinoma were analysed using quantitative real-time PCR. The difference between hsa-mi R-29 c and hsa-mi R-135 b expression profiles in the grouped samples was evaluated by ANOVA and Student's t-test tests. The results were adjusted for multiple testing by using Bonferroni's correction. P values ≤ 0.05 were considered statistically significant. To evaluate hsa-mi R-29 c and hsa-mi R-135 b expressions as potential biomarkers of gastric carcinogenesis, we performed a receiver operating characteristic curve analysis and the derived area under the curve, and a Categorical Principal Components Analysis. In silico identification of the genetic targets of hsa-mi R-29 c and hsa-mi R-135 b was performed using different prediction tools, in order to identify possible genes involved in gastric carcinogenesis.RESULTS: The expression levels of hsa-mi R-29 c were higher in normal gastric mucosal samples, and decreased progressively in non-atrophic chronic gastritis samples, intestinal metaplasia samples and intestinal-type gastric adenocarcinoma samples. The expression of hsa-mi R-29 c in the gastric lesions showed that non-atrophic gastritis have an intermediate profile to gastric normal mucosa and intestinal-type gastric adenocarcinoma, and that intestinal metaplasia samples presented an expression pattern similar to that in intestinal-type gastric adenocarcinoma. This micro RNA(mi RNA) has a good discriminatory accuracy between normal gastric samples and(1) intestinal-type gastric adenocarcinoma; and(2) intestinal metaplasia, and regulates the DMNT3 A oncogene. hsa-mi R-135 b is up-regulated in non-atrophic chronic gastritis and intestinal metaplasia samples and down-regulated in normal gastric mucosa and intestinal-type gastric adenocarcinoma samples. Non-atrophic chronic gastritis and intestinal metaplasia are significantly different from normal gastric mucosa samples. hsa-mi R-135 b expression presented a greater discriminatory accuracy between normal samples and gastric lesions. This mi RNA was associated with Helicobacter pylori presence in non-atrophic chronic gastritis samples and regulates the APC and KLF4 tumour suppressor genes.CONCLUSION: Our results provide evidence of epigenetic alterations in non-atrophic chronic gastritis and intestinal metaplasia and suggest that hsa-mi R-29 c and hsa-mi R-135 b are promising biomarkers of gastric carcinogenesis.Amanda Ferreira Vidal Aline MP Cruz Leandro Magalhães Adenilson L Pereira Ana KM Anaissi Nélisson CF Alves Paulo JBS Albuquerque Rommel MR Burbano Samia Demachki Ândrea Ribeiro-dos-Santos 2016World Journal of Gastroenterology2016,22,6:7
5Subclinical carotid atherosclerosis predicts all-cause mortality and cardiovascular events in obese patients with negative exercise echocardiography显示文摘BACKGROUND Obesity is a major health problem due to its high prevalence. The relationship between obesity and cardiovascular disease is unclear. Some studies agree that certain conditions associated with obesity, such as physical inactivity or cardiovascular risk factors, are responsible for cardiovascular risk excess among obese people. Carotid intima-media thickness and carotid plaques(CP) have been associated with cardiovascular adverse events in healthy populations, and recent data suggest a higher prevalence of subclinical carotid atherosclerosis in obese and metabolically unhealthy patients. However, there are no studies correlating subclinical atherosclerosis and adverse events(AE) in obese subjects.AIM To determine the association between carotid disease and AE in obese patients with negative exercise echocardiography(EE).METHODS From January 1, 2006 to December 31, 2010, 2000 consecutive patients with a suspicion of coronary artery disease were submitted for EE and carotid ultrasonography. Exclusion criteria included previous vascular disease, left ventricular ejection fraction < 50%, positive EE, significant valvular heart disease and inferior to submaximal EE. An AE was defined as all-cause mortality,myocardial infarction and cerebrovascular accident. Subclinical atherosclerosis was defined as CP presence according to Manheim and the American Society of Echocardiography Consensus.RESULTS Of the 652 patients who fulfilled the inclusion criteria, 226(34.7%) had body mass indexes ≥ 30 kg/m2, and 76 of them(33.6%) had CP. During a mean follow-up time of 8.2(2.1) years, 27 AE were found(11.9%). Mean event-free survival at 1, 5 and 10 years was 99.1%(0.6), 95.1%(1.4) and 86.5%(2.7), respectively. In univariate analysis, CP predicted AE [hazard ratio(HR) 2.52, 95% confidence interval(CI) 1.17-5.46; P = 0.019]. In multivariable analysis, the presence of CP remained a predictor of AE(HR 2.26, 95%CI 1.04-4.95, P = 0.041). Other predictors identified were glomerular filtration rate(HR 0.98, 95%CI 0.96-0.99; P= 0.023), peak metabolic equivalents(HR 0.83, 95%CI 0.70–0.99, P = 0.034) and moderate mitral regurgitation(HR 5.02, 95%CI 1.42–17.75, P = 0.012).CONCLUSION Subclinical atherosclerosis defined by CP predicts AE in obese patients with negative EE. These patients could benefit from aggressive prevention measures.Rafael Vidal-Perez Raúl Franco-Gutiérrez Alberto J Pérez-Pérez Virginia Franco-Gutiérrez Alberto Gascón-Vázquez Andrea López-López Ana María Testa-Fernández Carlos González-Juanatey 2019World Journal of Cardiology2019,11,1:7
6Personalizing therapies for gastric cancer: Molecular mechanisms and novel targeted therapies显示文摘Globally,gastric cancer is the 4thmost frequently diagnosed cancer and the 2ndleading cause of death from cancer,with an estimated 990000 new cases and738000 deaths registered in 2008.In the advanced setting,standard chemotherapies protocols acquired an important role since last decades in prolong survival.Moreover,recent advances in molecular therapies provided a new interesting weapon to treat advanced gastric cancer through anti-human epidermal growth factor receptor 2(HER2)therapies.Trastuzumab,an anti-HER2 monoclonal antibody,was the first target drug in the metastatic setting that showed benefit in overall survival when in association with platinum-5-fluorouracil based chemotherapy.Further,HER2 overexpression analysis acquired a main role in predict response for trastuzumab in this field.Thus,we conducted a review that will discuss the main points concerning trastuzumab and HER2 in gastric cancer,providing a comprehensive overview of molecular mechanisms and novel trials involved.Michael Luis Ana Tavares Liliana S Carvalho Lúcio Lara-Santos António Araújo Ramon Andrade de Mello 2013World Journal of Gastroenterology2013,19,38:6
7Gastric cancer in a Caucasian population: Role of pepsinogen C genetic variants显示文摘瞄准:在胃蛋白酶原 C (PGC ) 基因学习插入 / 删除多型性的角色,为胃粘膜的终端区别的一个有效标记,在到胃的损害的开发的危险性。方法:没有肿瘤的疾病的证据,学习与已知的胃的损害的 99 件样品和 127 件样品被执行。PCR 被采用, 6 多态的等位基因被放大:等位基因 1 (510 bp ) ,等位基因 2 (480 bp ) ,等位基因 3/4 (450/460 bp ) ,等位基因 5 (400 bp ) 并且等位基因 6 (310 bp ) 。结果:我们的结果表明等位基因 6 搬运人似乎对任何胃的损害的发展有保护(或 = 0.34;P<0.001 ) ,与象萎缩或肠的组织变形那样的胃的腺癌联系的 non-dysplastic 损害(或 = 0.28;P<0.001 ) 或侵略 GC (或 = 0.39;P = 0.004 ) 。结论:我们的学习表明等位基因 6 搬运人地位在胃的损害的发展有一个保护的角色,可能由于它有 PGC 的更高的表示的协会。而且,在控制组的等位基因 6 搬运人的频率比在亚洲人口获得了高是远的,它可能代表在白种人和亚洲人口之间的基因差距。Ana L Pinto-Correia Hugo Sousa Maria Fragoso Luís Moreira-Dias Carlos Lopes Rui Medeiros Mário Dinis-Ribeiro 2006World Journal of Gastroenterology2006,12,31:6
8Oxidative stress modulation in hepatitis C virus infected cells显示文摘Hepatitis C virus(HCV) replication is associated with the endoplasmic reticulum, where the virus can induce cellular stress. Oxidative cell damage plays an important role in HCV physiopathology. Oxidative stress is triggered when the concentration of oxygen species in the extracellular or intracellular environment exceeds antioxidant defenses. Cells are protected and modulate oxidative stress through the interplay of intracellular antioxidant agents, mainly glutathione system(GSH) and thioredoxin; and antioxidant enzyme systems such as superoxide dismutase, catalase, GSH peroxidase, and heme oxygenase-1. Also, the use of natural and synthetic antioxidants(vitamin C and E, N-acetylcysteine, glycyrrhizin, polyenylphosphatidyl choline, mitoquinone, quercetin, S-adenosylmethionine and silymarin) has already shown promising results as co-adjuvants in HCV therapy. Despite all the available information, it is not known how different agents with antiviral activity can interfere with the modulation of the cell redox state induced by HCV and decrease viral replication. This review describes an evidence-based consensus on molecular mechanisms involved in HCV replication and their relationship with cell damage induced by oxidative stress generated by the virus itself and cell antiviral machinery. It also describes some molecules that modify the levels of oxidative stress in HCV-infected cells.Sonia A Lozano-Sepulveda Owen L Bryan-Marrugo Carlos Cordova-Fletes Maria C Gutierrez-Ruiz Ana M Rivas-Estilla 2015World Journal of Hepatology2015,7,29:6
9Metabolic syndrome and colorectal neoplasms:An ominous association显示文摘AIM:To evaluate the association of metabolic syndrome(MS) and colorectal cancer and adenomas in a Western country,where the incidence of MS is over 27%.METHODS:This was a prospective study between March 2013 and March 2014.MS was diagnosed according to the National Cholesterol Education ProgramATP III.Demographic characteristics,anthropometric measurements,metabolic risk factors,and colonoscopic pathologic findings were assessed in patients with MS(group 1) who underwent routine colonoscopy at our department.This data was compared with consecutive patients without metabolic syndrome(group 2),with no differences regarding sex and age.Patients with incomplete colonoscopy,family history,or past history of colorectal neoplasm were excluded.Informed consent was obtained and the ethics committee approved this study.Statistical analysis was performed using Student's t-test and χ2 test,with a P value ≤ 0.05 being considered statistically significant.RESULTS:Of 258 patients,129 had MS;51% males;mean-age 67.1 years(50-87).Among the MS group,94% had high blood pressure,91% had increased waist circumference,60% had diabetes,55% had low high-density lipoprotein cholesterol level,50% had increased triglyceride level,and 54% were obese [body mass index(BMI) 30 kg/m2].51% presented 4 criteria of MS.MS was associated with increased prevalence of adenomas(43% vs 25%,P = 0.004) and colorectal cancer(13% vs 5%,P = 0.027),compared with patients without MS.MS was also positively associated with multiple(≥ 3) adenomas(35% vs 9%,P = 0.024) and sessile adenomas(69% vs 53%,P = 0.05).No difference existed between location(P = 0.086),grade of dysplasia(P = 0.196),or size(P= 0.841) of adenomas.In addition,no difference was found between BMI(P = 0.078),smoking(P = 0.146),alcohol consumption(P = 0.231),and the presence of adenomas.CONCLUSION:MS is positively associated with adenomas and colorectal cancer.However,there is not enough information in western European countries to justify screening in patients with MS.To our knowledge,no previous study has evaluated this association in Portuguese patients.Daniel Trabulo Suzane Ribeiro Cláudio Martins Cristina Teixeira Cláudia Cardoso Jo?o Mangualde Ricardo Freire élia Gamito Ana L Alves Fátima Augusto Ana P Oliveira Isabelle Cremers 2015World Journal of Gastroenterology2015,21,17:5
10Roscovitine sensitizes breast cancer cells to TRAIL-induced apoptosis through a pleiotropic mechanism显示文摘肿瘤坏死因素(TNF ) 联系了导致 apoptosis ligand (TRAIL/APO2L ) 是在血缘的死亡受体的约会之上导致 apoptosis 的 TNF 基因总科的一个成员。当小道对正常房间相对无毒时,它有选择地在许多转变房间导致 apoptosis。不过,胸肿瘤房间对小道的效果特别地抵抗。这里,我们报导在有 cyclin 依赖的 kinase 禁止者 roscovitine 的联合,落后于的暴露在检验的小道抵抗的乳癌房间线的多数导致了显著 apoptosis。Roscovitine 便于小道导致死亡的发信号的复杂形成和 caspase-8 的激活。FLICE 禁止的蛋白质是的 cFLIP (L) 和 cFLIP 显著地下面调整的列在后面暴露到 roscovitine 并且,确实由 siRNA 的 cFLIP isoforms 击倒敏化的胸肿瘤房间到导致小道的 apoptosis。另外,我们证明 roscovitine 强烈在胸肿瘤房间压制了 Mcl-1 表示和起来调整的 E2F1 蛋白质层次。显著地,由 siRNA 的 Mcl-1 的 silencing 敏化胸肿瘤房间到导致小道的 apoptosis。而且,由减少的 siRNA 的 E2F1 蛋白质击倒在导致小道的 apoptosis 的 roscovitine 的敏化的效果。在摘要,我们的结果为 roscovitine 的 pro-apoptotic 影响揭示 pleitropic 机制,加亮它象在在有小道的联合的乳癌的一个反肿瘤代理人的潜力。Gustavo Ortiz-Ferrón Rosario Yerbes Adriana Eramo Ana I López-Pérez Ruggero De Maria Abelardo Lápez-Rivas 2008Cell Research2008,18,6:5
11Validation of a new scoring system: Rapid assessment faecal incontinence score显示文摘AIM: To implement a quick and simple test- rapid assessment faecal incontinence score(RAFIS) and show its reliability and validity.METHODS: From March 2008 through March 2010, we evaluated a total of 261 consecutive patients, including 53 patients with faecal incontinence. Demographic and comorbidity information was collected. In a single visit, patients were administered the RAFIS. The results obtained with the new score were compared with those of both Wexner score and faecal incontinence quality of life scale(FIQL) questionnaire. The patient withoutinfluence of the surgeon completed the test. The role of surgeon was explaining the meaning of each section and how he had to fill. Reliability of the RAFIS score was measured using intra-observer agreement and Cronbach's alpha(internal consistency) coefficient. Multivariate analysis of the main components within the different scores was performed in order to determine whether all the scores measured the same factor and to conclude whether the information could be encompassed in a single factor. A sample size of 50 patients with faecal incontinence was estimated to be enough to detect a correlation of 0.55 or better at 5% level of significance with 80% power.RESULTS: We analysed the results obtained by 53 consecutive patients with faecal incontinence(median age 61.55 ± 12.49 years) in the three scoring systems. A total of 208 healthy volunteers(median age 58.41 ± 18.41 years) without faecal incontinence were included in the study as negative controls. Pearson's correlation coefficient between 'state' and 'leaks' was excellent(r = 0.92, P < 0.005). Internal consistency in the comparison of 'state' and 'leaks' yielded also excellent correlation(Cronbach's α = 0.93). Results in each score were compared using regression analysis and a correlation value of r = 0.98 was obtained with Wexner score. As regards FIQL questionnaire, the values of 'r ' for the different subscales of the questionnaire were: 'lifestyle' r =-0.87, 'coping/behaviour' r =-0.91, 'depression' r =-0.36 and 'embarrassment' r =-0.90,(P < 0.01). A multivariate analysis showed that all the scoring systems measured the same factor. A single factor may explain 80.84% of the variability of FI, so all the scoring systems measure the same factor. Patient's continence improves when RAFIS and Jorge-Wexner scores show low values and when the values obtained in the FIQL questionnaire are high.CONCLUSION: RAFIS is a valid and reliable tool to assess Faecal Incontinence.Fernando de la Portilla Arantxa Calero-Lillo Rosa M Jiménez-Rodríguez Maria L Reyes Manuela Segovia-González María Victoria Maestre Ana M García-Cabrera 2015World Journal of Gastrointestinal Surgery2015,7,9:5
12National natural capital accounting with the ecological footprint concept显示文摘Mathis Wackernagel Larry Onisto Patricia Bello Alejandro Callejas Linares Ina Susana López Falfán Jesus Méndez Garc??a Ana Isabel Suárez Guerrero Ma Guadalupe Suárez Guerrero 1999Ecological Economics1999,,3:5
13Aplastic anemia and severe pancytopenia during treatment with peg-interferon,ribavirin and telaprevir for chronic hepatitis C显示文摘Telaprevir and Boceprevir are the first direct acting antivirals approved for chronic hepatitis C in combination with peg-interferon alfa and ribavirin.Pancytopenia due to myelotoxicity caused by these drugs may occur,but severe hematological abnormalities or aplastic anemia(AA) have not been described.We collected all cases of severe pancytopenia observed during triple therapy with telaprevir in four Spanish centers since approval of the drug in 2011.Among 142 cirrhotic patients receiving treatment,7 cases of severe pancytopenia(5%) were identified and three were consistent with the diagnosis of AA.Mean age was 59 years,five patients had compensated cirrhosis and two patients had severe hepatitis C recurrence after liver transplantation.Severe pancytopenia was diagnosed a median of 10 wk after the initiation of therapy.Three patients had pre-treatment hematological abnormalities related to splenomegaly.In six patients,antiviral treatment was interrupted at the onset of hematological abnormalities.Two patients died due to septic complications and one patient due to acute alveolar hemorrhage.The remaining patients recovered.Severe pancytopenia and especially AA,are not rare during triple therapy with telaprevir in patients with advanced liver disease.Close monitoring is imperative in this setting to promptly detect serious hematological disorders and to prevent further complications.Sabela Lens Jose L Calleja Ana Campillo Jose A Carrion Teresa Broquetas Christie Perello Juan de la Revilla Zoe Marino Maria-Carlota Londono Jose M Sanchez-Tapias Alvaro Urbano-Ispizua Xavier Forns 2015World Journal of Gastroenterology2015,21,17:4
14Celiac disease serology in patients with different pretest probabilities: Is biopsy avoidable?显示文摘AIM: To establish the diagnostic performance of sev-eral serological tests, individually and in combination, for diagnosing celiac disease (CD) in patients with different pretest probabilities, and to explore potential se- rological algorithms to reduce the necessity for biopsy. METHODS: We prospectively performed duodenal biopsy and serology in 679 adults who had either high risk (n = 161) or low risk (n = 518) for CD. Blood samples were tested using six assays (enzyme-linked immunosorbent assay) that detected antibodies to tissue transglutaminase (tTG) and deamidated gliadin peptide (DGP). RESULTS: CD prevalence was 39.1% in the high-risk population and 3.3% in the low-risk group. In high-risk patients, all individual assays had a high diagnostic efficacy [area under receiving operator characteristic curves (AU ROC): 0.968 to 0.999]. In contrast, assays had a lower diagnostic efficacy (AU ROC: 0.835 to 0.972) in the low-risk group. Using assay combinations, it would be possible to reach or rule out diagnosis of CD without biopsy in 92% of cases in both pretest populations. We observed that the new DGP/tTG Screen assay resulted in a surplus compared to more conventional assays in any clinical situation. CONCLUSION: The DGP/tTG Screen assay could be considered as the best initial test for CD. Combinations of two tests, including a DGP/tTG Screen, might be able to diagnose CD accurately in different clinical scenarios making biopsy avoidable in a high proportion of subjects.Emilia Sugai María L Moreno Hui J Hwang Ana Cabanne Adriana Crivelli Fabio Nach-man Horacio Vázquez Sonia Niveloni Julio Argonz Roberto Mazure Graciela La Motta María E Caniggia Edgardo Smecuol Néstor Chopita Juan C Gómez Eduardo Maurińo Julio C Bai 2010World Journal of Gastroenterology2010,16,25:4
15Epstein-Barr virus is associated with gastric carcinoma: The question is what is the significance?显示文摘AIM: To examine the possible role of the Epstein- Barr Virus (EBV) in the development of gastric adenocarcinoma (GC). It is unclear whether EBV is involved in GC development or is a consequence of gastric inflammation secondary to immunosuppressive treatments. METHODS: A systematic review was carried out of all published observational studies on the temporal association between EBV and GC, with a view to determine a causal relationship. RESULTS: The present study showed that the worldwide crude prevalence of EBV in gastric adenocarcinoma was 8.29%. The prevalence varied from 7.08% for intestinal type and 9.82% for diffuse type of GC. It was observed that Western and Central Asian countries had a significantly higher frequency of EBV positive cases compared to South-Eastern countries. America had the highest EBV-GC prevalence whereas Europe had the lowest. CONCLUSION: The present review has demonstrated a high prevalence of EBV in gastric adenocarcinoma. However, studies designed to assess a temporal relationship and histological association using sensitive techniques should be carried out to establish the role of EBV in GC carcinogenesis.Hugo Sousa Ana L Pinto-Correia Rui Medeiros Mario Dinis-Ribeiro 2008World Journal of Gastroenterology2008,14,27:4
16Recombinant streptokinase vs phenylephrine-based suppositories in acute hemorrhoids, randomized, controlled trial(THERESA-3)显示文摘AIM: To compare the efficacy and safety of recombinant streptokinase(rSK) and phenylephrine-based suppositories in acute hemorrhoidal disease.METHODS: A multicenter(14 sites), randomized(1:1), open, parallel groups, active controlled trial was done. After inclusion, subjects with acute symptoms of hemorrhoids, who gave their written, informed consent to participate, were centrally randomized to receive, as outpatients, rSK(200000 IU) or 0.25% phenylephrine suppositories, which had different organoleptic characteristics. Treatment was administered by the rectal route, one unit every 6 h during 48 h for rSK, and up to a maximum of 5 d(20 suppositories) for phenylephrine. Evaluations were performed at 3, 5 and 10 d postinclusion. The main end-point was the 5th-day complete clinical response(disappearance of pain and edema, and ≥ 70% reduction of the lesion size). Time to response and need for thrombectomy were secondary efficacy variables. Adverse events were evaluated too. RESULTS: 5thday complete response rates were 83/110(75.5%) and 36/110(32.7%) with rSK and phenylephrine suppositories, respectively. This 42.7% difference(95%CI: 30.5-54.2) was highly significant(P < 0.001). The advantage was detected since the early 3rdday evaluation(37.3% vs 6.4% for the rSK and active control groups, respectively; P < 0.001) and was kept even at the late 10thday assessment(83.6% vs 58.2% for rSK and phenylephrine, respectively; P < 0.001). Time for complete response was significantly shorter(P = 0.031; log-rank test) in the rSK group(median: 4.9 d; 95%CI: 4.8-5.0) with respect to the active control(median: 9.8 d; 95%CI: 9.8-10.0). Thrombectomy was necessary in 1/59 and 8/57 patients with baseline thrombosis in the rSK and phenylephrine groups, respectively(P = 0.016). There were no adverse events attributable to the experimental treatment. CONCLUSION: rSK suppositories showed a significant advantage over a widely used over-the-counter phen-ylephrine preparation for the treatment of acute hemorrhoidal illness, with an adequate safety profile.Francisco Hernández-Bernal Georgina Castellanos-Sierra Carmen M Valenzuela-Silva Karem M Catasús-lvarez Roselin Valle-Cabrera Ana Aguilera-Barreto Pedro A López-Saura 2014World Journal of Gastroenterology2014,20,6:4
17National natural capital accounting with the ecological footprint concept显示文摘Mathis Wackernagel Larry Onisto Patricia Bello Alejandro Callejas Linares Ina Susana López Falfán Jesus Méndez Garc??a Ana Isabel Suárez Guerrero Ma Guadalupe Suárez Guerrero 1999Ecological Economics1999,,3:3
18Beta-blocker therapy in elderly patients with renal dysfunction and heart failure显示文摘OBJECTIVE To assess the role of beta-blockers(BB)in patients with chronic kidney disease(CKD)aged≥75 years.METHODS AND RESULTS From January 2008 to July 2014,we included 390 consecutive patients≥75 years of age with ejection fraction≤35%and glomerular filtration rate(GFR)≤60 m L/min per 1.73 m^2.We analyzed the relationship between treatment with BB and mortality or cardiovascular events.The mean age of our population was 82.6±4.1 years.Mean ejection fraction was 27.9%±6.5%.GFR was 60-45 m L/min per 1.73 m^2 in 50.3%of patients,45-30 m L/min per 1.73 m^2 in 37.4%,and<30 m L/min per 1.73 m^2 in 12.3%.At the conclusion of follow-up,67.4%of patients were receiving BB.The median follow-up was28.04(IR:19.41-36.67)months.During the study period,211 patients(54.1%)died and 257(65.9%)had a major cardiovascular event(death or hospitalization for heart failure).BB use was significantly associated with a reduced risk of death(HR=0.51,95%CI:0.35-0.74;P<0.001).Patients receiving BB consistently showed a reduced risk of death across the different stages of CKD:stage IIIa(GFR=30-45 m L/min per 1.73 m^2;HR=0.47,95%CI:0.26-0.86,P<0.0001),stage IIIb(GFR 30-45 m L/min per 1.73 m^2;HR=0.55,95%CI:0.26-1.06,P=0.007),and stages IV and V(GFR<30 m L/min per 1.73 m~2;HR=0.29,95%CI:0.11-0.76;P=0.047).CONCLUSIONS The use of BB in elderly patients with HFr EF and renal impairment was associated with a better prognosis.Use of BB should be encouraged when possible.Juan Martínez-Milla Marcelino Cortés García Julia Anna Palfy Mikel Taibo Urquía Marta López Castillo Ana Devesa Arbiol Ana Lucía Rivero Monteagudo María Luisa Martín Mariscal Inés Jiménez-Varas Sem Briongos Figuero Juan Antonio Franco-Pelaéz JoséTuñón 2021Journal of Geriatric Cardiology2021,18,1:3
19Clinical outcomes with a new microincisional diffractive multifocal IOL显示文摘Background:To evaluate the refractive outcomes and the optical performance as well as the quality of life in patients implanted with a new diffractive multifocal intraocular lens(IOL).Methods:Prospective,clinical study including 41 cases of patients who underwent cataract surgery and were divided in two groups:group 1,including 20 eyes implanted with the multifocal IOL SeeLens MF(Hanita Lenses,Israel);group 2,21 eyes implanted with the Acrysof SA60AT IOL.Visual acuity,defocus curve,intraocular aberrations,contrast sensitivity function and quality of life were assessed during a follow up period of 6 months.Results:Significant improvement was observed in the uncorrected distance visual acuity(UDVA)and corrected distance visual acuity(CDVA)in both groups(p<0.02).The multifocal group showed better results in terms of uncorrected near visual acuity(UNVA)and distance-corrected near visual acuity(DCNVA)(p<0.01).Comparison of both groups showed better visual acuities for the multifocal IOL group in defocus levels from-3.0 D to-1.50 D(p≤0.01).At 6 months,there was a significant reduction of the internal higher order aberrations(p≤0.04).A significant increase in scotopic contrast sensitivity was detected for 6 cycles/°spatial frequency during follow up(p=0.04),but no significant changes were observed for the rest of spatial frequencies(p≥0.06).Visual Functioning Index(VF-14)questionnaire showed that patients reported high levels of satisfaction when performing daily tasks.Conclusions:The SeeLens MF IOL is able to successfully restore distance,near and intermediate visions after cataract surgery.It also provides functional intermediate vision with optimal intraocular optical quality.Jorge L Alió Alfredo Vega-Estrada Ana B Plaza-Puche 2015Eye and Vision2015,2,1:3
20Menopause and cognitive impairment:A narrative review of current knowledge显示文摘A severe impairment of cognitive function characterizes dementia.Mild cognitive impairment represents a transition between normal cognition and dementia.The frequency of cognitive changes is higher in women than in men.Based on this fact,hormonal factors likely contribute to cognitive decline.In this sense,cognitive complaints are more common near menopause,a phase marked by a decrease in hormone levels,especially estrogen.Additionally,a tendency toward worsened cognitive performance has been reported in women during menopause.Vasomotor symptoms(hot flashes,sweating,and dizziness),vaginal dryness,irritability and forgetfulness are common and associated with a progressive decrease in ovarian function and a subsequent reduction in the serum estrogen concentration.Hormone therapy(HT),based on estrogen with or without progestogen,is the treatment of choice to relieve menopausal symptoms.The studies conducted to date have reported conflicting results regarding the effects of HT on cognition.This article reviews the main aspects of menopause and cognition,including the neuroprotective role of estrogen and the relationship between menopausal symptoms and cognitive function.We present and discuss the findings of the central observational and interventional studies on HT and cognition.Délio Marques Conde Roberto Carmignani Verdade Ana L R Valadares Lucas F B Mella Adriana OrcesiPedro Lucia Costa-Paiva 2021World Journal of Psychiatry2021,11,8:3
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