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| 1 | Adjuvant and neoadjuvant treatment in pancreatic cancer显示文摘Pancreatic adenocarcinoma is one of the most aggressive human malignancies,ranking 4th among causes for cancer-related death in the Western world including the United States.Surgical resection offers the only chance of cure,but only 15 to 20 percent of cases are potentially resectable at presentation.Different studies demonstrate and confirm that advanced pancreatic cancer is among the most complex cancers to treat and that these tumors are relatively resistant to chemotherapy and radiotherapy.Currently there is no consensus around the world on what constitutes'standard'adjuvant therapy for pancreatic cancer.This controversy derives from several studies,each fraught with its own limitations.Standards of care also vary somewhat with regard to geography and economy,for instance chemo-radiotherapy followed by chemotherapy or vice versa is considered the optimal therapy in North America while chemotherapy alone is the current standard in Europe.Regardless of the efforts in adjuvant and neoadjuvant improved therapy,the major goal to combat pancreatic cancer is to find diagnostic markers,identifying the disease in a pre-metastatic stage and making a curative treatment accessible to more patients.In this review,authors examined the different therapy options for advanced pancreatic patients in recent years and the future directions in adjuvant and neoadjuvant treatments for these patients. | Marta Herreros-Villanueva Elizabeth Hijona Angel Cosme Luis Bujanda | 2012 | World Journal of Gastroenterology2012，18，14： | 11 |
| 2 | Mouse models of pancreatic cancer显示文摘Pancreatic cancer is one of the most lethal of human malignancies ranking 4th among cancer-related death in the western world and in the United States,and potent therapeutic options are lacking.Although during the last few years there have been important advances in the understanding of the molecular events responsible for the development of pancreatic cancer,currently specific mechanisms of treatment resistance remain poorly understood and new effective systemic drugs need to be developed and probed.In vivo models to study pancreatic cancer and approach this issue remain limited and present different molecular features that must be considered in the studies depending on the purpose to fit special research themes.In the last few years,several genetically engineered mouse models of pancreatic exocrine neoplasia have been developed.These models mimic the disease as they reproduce genetic alterations implicated in the progression of pancreatic cancer.Genetic alterations such as activating mutations in KRas,or TGFb and/or inactivation of tumoral suppressors such as p53,INK4A/ARF BRCA2 and Smad4 are the most common drivers to pancreatic carcinogenesis and have been used to create transgenic mice.These mouse models have a spectrum of pathologic changes,from pancreatic intraepithelial neoplasia to lesions that progress histologically culminating in fully invasive and metastatic disease and represent the most useful preclinical model system.These models can characterize the cellular and molecular pathology of pancreatic neoplasia and cancer and constitute the best tool to investigate new therapeutic approaches,chemopreventive and/or anticancer treatments.Here,we review and update the current mouse models that reproduce different stages of human pancreatic ductal adenocarcinoma and will have clinical relevance in future pancreatic cancer developments. | Marta Herreros-Villanueva Elizabeth Hijona Angel Cosme Luis Bujanda | 2012 | World Journal of Gastroenterology2012，18，12： | 8 |
| 3 | Malignant colorectal polyps显示文摘Nowadays, the number of cases in which malignant colorectal polyps are removed is increasing due to colorectal cancer screening programmes. Cancerous polyps are classified into non-invasive high grade neoplasia (NHGN), when the cancer has not reached the muscularis mucosa, and malignant polyps, classed as T1, when they have invaded the submucosa. NHGN is considered cured with polypectomy, while the prognosis for malignant polyps depends on various morphological and histological factors. The prognostic factors include, sessile or pedunculated morphology of the polyp, whether partial or en bloc resection is carried out, the degree of differentiation of the carcinoma, vascular or lymphatic involvement, and whether the polypectomy resection margin is tumor free. A malignant polyp at T1 is considered cured with polypectomy ifit is a pedunculated polyp (Ip of the Paris classification), it has been completely resected, it is not poorly differentiated, the resection edge is not affected by the tumor and there is no vascular or lymphatic involvement. The sessile malignant polyp (Is of the Paris classification) at T1 is considered not cured with polypectomy. Only in some cases (e.g. older people with high surgical risk) local excision(polypectomy or endoscopic submucosal dissection or conventional endoscopic mucosal resection) is considered the definitive treatment. | Luis Bujanda Angel Cosme Ines Gil Juan I Arenas-Mirave | 2010 | World Journal of Gastroenterology2010，16，25： | 4 |
| 4 | Antimicrobial susceptibility testing before first-line treatment for Helicobacter pylori infection in patients with dual or triple antibiotic resistance显示文摘AIM To evaluate the efficacy of antimicrobial susceptibilityguided therapy before first-line treatment for infection in patients with dual or triple antibiotic resistance.METHODS A total of 1034 patients infected by Helicobacter pylori(H. pylori) during 2013-2014 were tested for antimicrobial susceptibility. 157 of 1034(15%) patients showed resistance to two(127/1034; 12%) and to three(30/1034; 3%) antibiotics. Sixty-eight patients with dual H. pylori-resistance(clarithromycin, metronidazole or levofloxacin) were treated for 10 d with triple therapies: OAL(omeprazole 20 mg b.i.d., amoxicillin 1 g b.i.d., and levofloxacin 500 mg b.i.d.) 43cases, OAM(omeprazole 20 mg b.i.d., amoxicillin 1 g b.i.d., and metronidazole 500 mg b.i.d.) 12 cases and OAC(omeprazole 20 mg b.id., amoxicillin 1 g b.i.d., and clarithromycin 500 mg b.i.d.) 13 cases based on the antimicrobial susceptibility testing. Twelve patients showed triple H. pylori-resistance(clarithromycin, metronidazole and levofloxacin) and received for 10 d triple therapy with OAR(omeprazole 20 mg b.id., amoxicillin 1 g b.i.d., and rifabutin 150 mg b.i.d.). Eradication was confirmed by 13C-urea breath test. Adverse effects and compliance were assessed by a questionnaire. RESULTS Intention-to-treat eradication rates were: OAL(97.6%), OAM(91.6%), OAC(92.3%) and OAR(58.3%). Cure rate was significantly higher in na?ve patients treated with OAR-10 compared to patients who had two or three previous treatment failures(83% vs 33%). Adverse events rates for OAL, OAM, OAC and OAR were 22%, 25%, 23% and 17%, respectively, all of them mild-moderate. CONCLUSION Antimicrobial susceptibility-guided triple therapies during 10 d for first-line treatment leads to an eradication rate superior to 90% in patients with dual antibiotic H. pylori resistance. | Angel Cosme Milagrosa Montes Begona Ibarra Esther Tamayo Horacio Alonso Usua Mendarte Jacobo Lizasoan Marta Herreros-Villanueva Luis Bujanda | 2017 | World Journal of Gastroenterology2017，23，18： | 4 |
| 5 | Alcohol consumption on pancreatic diseases显示文摘Although the association between alcohol and pancreatic diseases has been recognized for a long time,the impact of alcohol consumption on pancreatitis and pancreatic cancer(PC)remains poorly defined.Nowadays there is not consensus about the epidemiology and the beverage type,dose and duration of alcohol consumption causing these diseases.The objective of this study was to review the epidemiology described in the literature for pancreatic diseases as a consequence of alcoholic behavior trying to understand the association between dose,type and frequency of alcohol consumption and risk of pancreatitis and PC.The majority of the studies conclude that high alcohol intake was associated with a higher risk of pancreatitis(around 2.5%-3% between heavy drinkers and 1.3%between non drinkers).About 70%of pancreatitis are due to chronic heavy alcohol consumption.Although this incidence rate differs between countries,it is clear that the risk of developing pancreatitis increases with increasing doses of alcohol and the average of alcohol consumption vary since 80 to 150 g/d for 10-15 years.With regard to PC, the role of alcohol consumption remains less clear,and low to moderate alcohol consumption do not appear to be associated with PC risk,and only chronic heavy drinking increase the risk compared with lightly drinkers.In a population of 10%-15%of heavy drinkers, 2%-5%of all PC cases could be attributed to alcohol consumption.However,as only a minority(less than 10%for pancreatitis and 5%for PC)of heavily drinkers develops these pancreatic diseases,there are other predisposing factors besides alcohol involved.Genetic variability and environmental exposures such as smoking and diet modify the risk and should be considered for further investigations. | Marta Herreros-Villanueva Elizabeth Hijona Jesus Maria Baales Angel Cosme Luis Bujanda | 2013 | World Journal of Gastroenterology2013，19，5： | 3 |
| 6 | Prognosis and follow-up of 135 patients with ischemic colitis over a five-year period显示文摘AIM:To study the prognosis(recurrence and mortality)of patients with ischemic colitis(IC).METHODS:This study was conducted in four Spanish hospitals,participants in the Ischemic Colitis in Spain study We analyzed prospectively 135 consecutive patients who met criteria for definitive or probable IC according to Brandt criteria,and follow up these patients during the next five years,retrospectively.Long-term results(recurrence and mortality)were evaluated retrospectively after a median interval of 62 mo(range54-75 mo).RESULTS:Estimated IC recurrence rates were 2.9%,5.1%,8.1%and 9.7%at years 1,2,3 and 5 years,respectively.Five-year survival was 69%(93 of 135)and 24%(10 of 42 patients)died for causes related to the IC.Among these 10 patients,8 died in their first episode at hospital(4 had gangrenous colitis and 4 fulminant colitis)and 2 due to recurrence.CONCLUSION:The five-year recurrence rate of IC was low.On the other hand,mortality during follow-up was high and was not associated with ischemic colitis. | Angel Cosme Miguel Montoro Santos Santolaria Ana B Sanchez-Puertolas Marta Ponce Margarita Durán Jose Luis Cabriada Nerea Borda Cristina Sarasqueta Luis Bujanda | 2013 | World Journal of Gastroenterology2013，19，44： | 2 |
| 7 | Clinical patterns and outcomes of ischaemic colitis: Results of the Working Group for the Study of Ischaemic Colitis in Spain (CIE study)显示文摘 | Miguel A. Montoro Lawrence J. Brandt Santos Santolaria Fernando Gomollon Belén Sánchez Puértolas Jesús Vera Luis. Bujanda Angel Cosme José Luis Cabriada Margarita Durán Laura Mata Ana Santamaría Gloria Ce?a Jose Manuel Blas Julio Ponce Marta Ponce Luis Ro | 2011 | Scandinavian Journal of Gastroenterology2011，，2： | 1 |
| 8 | Molecular and Clinical Characteristics in 46 Families Affected with Peutz–Jeghers Syndrome显示文摘 | Hamid Mehenni Nicoletta Resta Ginevra Guanti Louisa Mota-Vieira Aaron Lerner Mohammed Peyman Kim A. Chong Larbi Aissa Ali Ince Angel Cosme Michael C. Costanza Colette Rossier Uppala Radhakrishna Randall W. Burt Didier Picard | 2007 | Digestive Diseases and Sciences2007，，8： | 1 |
| 9 | Cytomegalovirus hepatitis and myopericarditis显示文摘Cytomegalovirus (CMV) infection in inmunocompetent hosts generally is asymptomatic or may present as a mononucleosis syndrome but rarely can lead to severe organ complications. We report a case of simultaneous hepatic and pericardic CMV infection in a 36-year old immunocompetent man. He was admitted to coronary unit with fever, chest pain radiated to shoulders, changes on electrocardiogram with diffuse ST elevation and modest laboratory elevations in the MB fraction of creatine kinase (CK-MB) of 33.77 μg/L (0.1-6.73), serum cardiac troponin T of 0.904 ng/mL (0-0.4), creatine kinase of 454 U/L (20-195) and myoglobin of 480.4 μg/L (28-72). Routine laboratory test detected an elevation of aminotransferase level: alanine aminotransferase 1445 U/L, aspartate aminotransferase 601 U/L. We ruled out other causes of hepatitis with normal results except IgM CMV. The patient was diagnosed with myopericarditis and hepatitis caused by cytomegalovirus and started symptomatic treatment with salicylic acid. In few days the laboratory findings became normal and the patient was discharged. | Leire Zubiaurre Eva Zapata Luis Bujanda María Castillo Igor Oyarzabal Maria A Gutiérrez-Stampa Angel Cosme | 2007 | World Journal of Gastroenterology2007，13，4： | 1 |
| 10 | Spontaneous regression of pancreatic cancer: Real or a misdiagnosis?显示文摘Spontaneous tumor regression has been subject of numerous studies and speculations for many years. This phenomenon is exceptional, but well reported, in some types of tumors, but not in pancreatic cancer. Pancreatic cancer has the worst five-year survival rate of any cancer. Despite numerous molecular studies and clinical approaches, using several mouse models, this cancer responds poorly to the existing chemotherapeutic agents and progress on treatment remains elusive. Although pancreatic cancer tumors seldom undergo spontaneous regression, and some authors take that with skepticism, there are some cases reported in the literature. However, the variability in the description of the reports and technical details could make this process susceptible to misdiagnosis. Distinguishing between different types of pancreatic carcinoma should be taken with caution as they have wide differences in malignant potential. Diseases such as pancreatic benign tumors, insulinomas, or autoimmune pancreatitis could be responsible for this misdiagnosis as a pancreatic cancer. Here we review different cases reported, their clinical characteristics, and possible mechanisms leading to spontaneous regression of pancreatic cancer. We also discuss the possibilities of misdiagnosis. | Marta Herreros-Villanueva Elizabeth Hijona Angel Cosme Luis Bujanda | 2012 | World Journal of Gastroenterology2012，18，23： | 0 |
| 11 | Epidemiological assessment of intestinal parasitic infections in dogs at animal shelter in Veracruz,Mexico显示文摘Objective:To determine the prevalence of infection with intestinal parasites in 101 dogs in an animal shelter in Veracruz.Mexico,and investigate whether any general characteristics of the dogs were associated with infections.Methods:Parasitologiesl examination of fecal samples from the dogs was performed by means of centrifuge-flotation using Sheather's sucrose and zinc sulfate flotation media.In addition,hematocrit was determined in each canine blood sample.Results:Intestinal parasites were found in 99(98.0%) of the 101 dogs studied.About five different intestinal parasites were identified:Ancylostoma caninum in 89 dogs(88.1%).Giardia canis in 46(45.5%).Unciiuiria stenocephalia in 43(42.6%).Trichuris vulpis in 19(18.8%)and Strongyloides canis in 16(15.8%).Multivariate analysis showed:I) Giardia infection was associated with young age and mixed breed;2) Ancylostoma was associated with young age and no rabies vaccination:and 3) Strongyloides was associated with no rabies vaccination.Unciiuiria and Trichuris infections were not associated with the variables assessed.Conclusions:A high prevalence of intestinal parasites was found in the dogs studied.This suggests that the environment is highly contaminated with intestinal parasites.Preventive and therapeutic measures should be taken against infection with intestinal parasites in dogs in this region. | Cosme Alvarado-Esquivel Dora Romero-Salas Mariel Aguilar-Domínguez Anabel Cruz-Romero Nelly Ibarra-Priego dalberto Angel Pérez-de-Len | 2015 | Asian Pacific Journal of Tropical Biomedicine2015，5，1： | 0 |
| 12 | Colorectal cancer prognosis twenty years later显示文摘AIM:To evaluate changes in colorectal cancer(CRC) survival over the last 20 years.METHODS:We compared two groups of consecutive CRC patients that were prospectively recruited:Group Ⅰincluded 1990 patients diagnosed between 1980 and 1994.GroupⅡincluded 871 patients diagnosed in 2001.RESULTS:The average follow up time was 21 mo(1-229)for GroupⅠand 50 mo(1-73.4)for GroupⅡ.Overall median survival was significantly longer in Group Ⅱthan in GroupⅠ(73 mo vs 25 mo,P<0.001)and the difference was significant for all tumor stages.Post surgical mortality was 8% for GroupⅠand 2% for Group Ⅱ(P<0.001).Only 17% of GroupⅠpatients received chemotherapy compared with 50% of GroupⅡpatients(P<0.001).CONCLUSION:Survival in colorectal cancer patients has doubled over the past 20 years.This increase seems to be partly due to the generalization in the administration of chemotherapy and to the decrease of post surgical mortality. | Luis Bujanda Cristina Sarasqueta Elisabeth Hijona Lander Hijona Angel Cosme Ines Gil Jose Luis Elorza Jose I Asensio Santiago Larburu José M Enríquez-Navascués Rodrigo Jover Francesc Balaguer Xavier Llor Xavier Bessa Montserrat Andreu Artemio Paya Antoni Castells Gastrointestinal Oncology Group of the Spanish Gastroenterological Association | 2010 | World Journal of Gastroenterology2010，16，7： | 0 |
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