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| 1 | Watch and wait approach in rectal cancer:Current controversies and future directions显示文摘According to the main international clinical guidelines,the recommended treatment for locally-advanced rectal cancer is neoadjuvant chemoradiotherapy followed by surgery.However,doubts have been raised about the appropriate definition of clinical complete response(cCR)after neoadjuvant therapy and the role of surgery in patients who achieve a cCR.Surgical resection is associated with significant morbidity and decreased quality of life(QoL),which is especially relevant given the favourable prognosis in this patient subset. Accordingly, therehas been a growing interest in alternative approaches with less morbidity,including the organ-preserving watch and wait strategy, in which surgery isomitted in patients who have achieved a cCR. These patients are managed with aspecific follow-up protocol to ensure adequate cancer control, including the earlyidentification of recurrent disease. However, there are several open questionsabout this strategy, including patient selection, the clinical and radiologicalcriteria to accurately determine cCR, the duration of neoadjuvant treatment, therole of dose intensification (chemotherapy and/or radiotherapy), optimal followupprotocols, and the future perspectives of this approach. In the present review,we summarize the available evidence on the watch and wait strategy in thisclinical scenario, including ongoing clinical trials, QoL in these patients, and thecontroversies surrounding this treatment approach. | Fernando López-Campos Margarita Martín-Martín Roberto Fornell-Pérez Juan Carlos García-Pérez Javier Die-Trill Raquel Fuentes-Mateos Sergio López-Durán JoséDomínguez-Rullán Reyes Ferreiro AlejandroRiquelme-Oliveira Asunción Hervás-Morón Felipe Couñago | 2020 | World Journal of Gastroenterology2020，26，29： | 10 |
| 2 | Radiological response and inflammation scores predict tumour recurrence in patients treated with transarterial chemoembolization before liver transplantation显示文摘AIM To investigate the prognostic value of the radiological response after transarterial chemoembolization(TACE)and inflammatory markers in patients affected by hepatocellular carcinoma(HCC)awaiting liver transplantation(LT).METHODS We retrospectively evaluated the preoperative pre dictors of HCC recurrence in 70 patients treated with conventional(n=16)or doxorubicin-eluting bead TACE(n=54)before LT.The patient and tumour characteristics,including the static and dynamic alpha-fetoprotein,neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio( LR)measurements,were recorded.Treatment response was classified according to the modified Response Evaluation Criteria in Solid Tumours(m RECIST)and the European Association for the Study of the Liver(EASL)criteria as complete response(CR),partial response( R),stable disease o progressive disease.After examination of the explanted livers,histological necrosis was classified as complete(100%of the cumulative tumour area),partia(50%-99%)or minimal(<50%)and was correlated with the preoperative radiological findings.RESULTS According to the pre-TACE radiological evaluation,22/70(31.4%)and 12/70(17.1%)patients were beyond Milan and University of San Francisco(UCSF)criteria,respectively.After TACE procedures,the objective response(CR+ R)rates were 71.4%and 70.0%according to m RECIST and EASL criteria,respectively.The agreement between the two guidelines in defining the radiological response was rated as very good both for the overall and target lesion response(weighted k-value:0.98 and 0.93,respectively).Complete and partial histological necrosis were achieved in 14/70(20.0%)and 28/70(40.0%)patients,respectively.Using histopathology as the reference standard,m RECIST criteria correctly classified necrosis in 72.9%(51/70)of patients and EASL criteria in 68.6%(48/70)of cases.The m RECIST non-response to TACE[Exp(b)=9.2, =0.012],exceeding UCSF criteria before TACE[Exp(b)=4.7, =0.033]and a preoperative LR>150[Exp(b)=5.9, =0.046]were independent predictors of tumour recurrence.CONCLUSION The radiological response and inflammatory markers are predictive of tumour recurrence and allow the proper selection of TACE-treated candidates for LT. | Daniele Nicolini Andrea Agostini Roberto Montalti Federico Mocchegiani Cinzia Mincarelli Alessandra Mandolesi Nicola L Robertson Roberto Candelari Andrea Giovagnoni Marco Vivarelli | 2017 | World Journal of Gastroenterology2017，23，20： | 4 |
| 3 | Celiac 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 | 2010 | World Journal of Gastroenterology2010，16，25： | 4 |
| 4 | European experts consensus statement on cystic tumours of the pancreas显示文摘 | Marco Del Chiaro Caroline Verbeke Roberto Salvia Gunter Kl?ppel Jens Werner Colin McKay Helmut Friess Riccardo Manfredi Eric Van Cutsem Matthias L?hr Ralf Segersv?rd | 2013 | Digestive and Liver Disease2013，，： | 3 |
| 5 | Celecoxib enhances the detoxification of diethylnitrosamine in rat liver cancer显示文摘AIM:To study the effect of celecoxib(CXB) on diethylnitrosamine activation through the regulation of cytochrome P450 in a hepatocarcinogenesis model.METHODS:Six-week-old male Sprague-Dawley rats were randomly divided into fi ve groups,a non-treated group(NT) ,a diethylnitrosamine-treated group(DEN) ,a DEN+CXB-treated group(DEN+CXB) ,and CXB 8 d-treated and CXB 32 d-treated groups.The effects of celecoxib on the enzymatic activities of CYP1A1,2A,2B1/2,and 2E1 were assessed in hepatic microsomes 24 h after DEN administration.Changes in CYP1A1 and CYP2B1/2 protein expression were also evaluated.The rate of DEN metabolism was measured by the production of the deethylation metabolite acetaldehyde,and the denitrosation metabolite nitrite.RESULTS:DEN+CXB administration produced a significant increase in the enzymatic activities of CYP2B1/2 and 1A1,whereas it did not change the activities of CYP2A and 2E1,compared to that of the DEN group.CXB treatment for eight days did not produce a signif icant effect on enzymatic activity when compared to the NT group;however,when it was administered for prolonged times(CXB 32 d group) ,the enzymatic activities were increased in a similar pattern to those in the DEN+CXB group.The observed increase in the enzymatic activities in the DEN+CXB group was accompanied by an increase in the CYP2B1/2 protein levels;no changes were observed in the levels of CYP1A1.In vitro,CXB increased the denitrosation of DEN,a pathway of metabolic detoxification.The addition of SKF-525A,a preferential inhibitor of CYP2B,abrogated the denitrosation of DEN.CONCLUSION:These results suggest that the mechanism of action of CXB involves enhancement of the detoxif ication of DEN by an increasing denitrosation via CYP2B1/2. | Martha Estela Salcido-Neyoy Adolfo Sierra-Santoyo Olga Beltrán-Ramírez José Roberto Macías-Pérez Saúl Villa-Trevio | 2009 | World Journal of Gastroenterology2009，15，19： | 3 |
| 6 | Circulating leptin and its muscle gene expression in Nellore cattle with divergent feed efficiency显示文摘Background: Leptin has a strong relation to important traits in animal production, such as carcass composition,feed intake, and reproduction. It is mainly produced by adipose cells and acts predominantly in the hypothalamus.In this study, circulating leptin and its gene expression in muscle were evaluated in two groups of young Nellore bulls with divergent feed efficiency. Individual dry matter intake(DMI) and average daily gain(ADG) of 98 Nellore bulls were evaluated in feedlot for 70 d to determinate the residual feed intake(RFI) and select 20 animals for the high feed efficient(LRFI) and 20 for the low feed efficient(HRFI) groups. Blood samples were collected on d 56 and at slaughter(80 d) to determine circulating plasma leptin. Samples of Longissimus dorsi were taken at slaughter for leptin gene expression levels.Results: DMI and RFI were different between groups and LRFI animals showed less back fat and rump fat thickness,as well as less pelvic and kidney fat weight. Circulating leptin increased over time in all animals. Plasma leptin was greater in LRFI on 56 d and at slaughter(P = 0.0049). Gene expression of leptin were greater in LRFI animals(P = 0.0022) in accordance with the plasma levels. The animals of the LRFI group were leaner, ate less, and had more circulating leptin and its gene expression.Conclusion: These findings demonstrated that leptin plays its physiological role in young Nellore bulls, probably controlling food intake because feed efficient animals have more leptin and lower residual feed intake. | Lúcio Flávio Macedo Mota Cristina Moreira Bonafé Pamela Almeida Alexandre Miguel Henrique Santana Francisco JoséNovais Erika Toriyama Aldrin Vieira Pires Saulo da Luz Silva Paulo Roberto Leme JoséBento Sterman Ferraz Heidge Fukumasu | 2018 | Journal of Animal Science and Biotechnology2018，9，1： | 3 |
| 7 | Menopause 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 | 2021 | World Journal of Psychiatry2021，11，8： | 3 |
| 8 | Gastric cancer in relation to the intake of nutrients involved in one-carbon metabolism among MTHFR 677 TT carriers显示文摘 | Marcia V. Galván-Portillo Alejandra Cantoral Luis F. O?ate-Oca?a Jia Chen Roberto Herrera-Goepfert Luisa Torres-Sanchez Raul U. Hernandez-Ramirez Oswaldo Palma-Coca Lizbeth López-Carrillo | 2009 | European Journal of Nutrition2009，，5： | 3 |
| 9 | Central nervous system vasculitis and polyneuropathy as first manifestations of hepatitis C显示文摘Sensory or motor peripheral neuropathy may be observed in a significant proportion of hepatitis C virus (HCV)-infected patients.However,central nervous system (CNS) involvement is uncommon,especially in cryoglobulin-negative subjects.We describe a case of peripheral neuropathy combined with an ischemic CNS event as primary manifestations of chronic HCV infection without cryoglobulinemia.Significant improvement was observed after antiviral therapy.We discuss the spectrum of neurological manifestations of HCV infection and review the literature. | Roberto J Carvalho-Filho Janaína Luz Narciso-Schiavon Luciano HL Tolentino Leonardo L Schiavon Maria Lucia G Ferraz Antonio Eduardo B Silva | 2012 | World Journal of Gastroenterology2012，18，2： | 3 |
| 10 | Liver fat deposition and mitochondrial dysfunction in morbid obesity:An approach combining metabolomics with liver imaging and histology显示文摘AIM: To explore the usefulness of magnetic resonance imaging(MRI) and spectroscopy(MRS) for assessment of non-alcoholic fat liver disease(NAFLD) as compared with liver histological and metabolomics findings. METHODS: Patients undergoing bariatric surgery following procedures involved in laparoscopic sleeve gastrectomy were recruited as a model of obesityinduced NAFLD in an observational, prospective, singlesite, cross-sectional study with a pre-set duration of 1 year. Relevant data were obtained prospectively and surrogates for inflammation, oxidative stress and lipid and glucose metabolism were obtained through standard laboratory measurements. To provide reliable data from MRI and MRS, novel procedures were designed to limit sampling variability and other sources of error using a 1.5T Signa HDx scanner and protocols acquired from the 3D or 2D Fat SAT FIESTA prescription manager. We used our previously described 1H NMRbased metabolomics assays. Data were obtained immediately before surgery and after a 12-mo period including histology of the liver and measurement of metabolites. Values from 1H NMR spectra obtained after surgery were omitted due to technical limitations.RESULTS: MRI data showed excellent correlation with the concentration of liver triglycerides, other hepatic lipid components and the histological assessment, w h i c h e xc l u d e d t h e p r e s e n c e o f n o n-a l c o h o l i c steatohepatitis(NASH). MRI was sufficient to follow up NAFLD in obese patients undergoing bariatric surgery and data suggest usefulness in other clinical situations. The information provided by MRS replicated that obtained by MRI using the-CH3 peak(0.9 ppm), the-CH2- peak(1.3 ppm, mostly triglyceride) and the-CH=CH- peak(2.2 ppm). No patient depicted NASH. After surgery all patients significantly decreased their body weight and steatosis was virtually absent even in patients with previous severe disease. Improvement was also observed in the serum concentrations of selected variables. The most relevant findings using metabolomics indicate increased levels of triglyceride and monounsaturated fatty acids in severe steatosis but those results were accompanied by a significant depletion of diglycerides, polyunsaturated fatty acids, glucose-6-phosphate and the ATP/AMP ratio. Combined data indicated the coordinated action on mitochondrial fat oxidation and glucose transport activity and may support the consideration of NAFLD as a likely mitochondrial disease. This concept may helpto explain the dissociation between excess lipid storage in adipose tissue and NAFLD and may direct the search for plasma biomarkers and novel therapeutic strategies. A limitation of our study is that data were obtained in a relatively low number of patients.CONCLUSION: MRI is sufficient to stage NAFLD in obese patients and to assess the improvement after bariatric surgery. Other data were superfluous for this purpose. | Nahum Calvo Raúl Beltrán-Debón Esther Rodríguez-Gallego Anna Hernández-Aguilera Maria Guirro Roger Mariné-Casadó Lidón Millá Josep M Alegret Fàtima Sabench Daniel del Castillo María Vinaixa Miguelàngel Rodríguez Xavier Correig Roberto García-álvarez Javier A Menendez Jordi Camps Jorge Joven | 2015 | World Journal of Gastroenterology2015，21，24： | 2 |
| 11 | Model for end-stage liver disease-Na score or Maddrey discrimination function index, which score is best?显示文摘AIM: To compare the ability of model for end-stage liver disease(MELD)-Na and Maddrey discrimination function index(DFI) to predict mortality at 30 and 90 d in patients with alcoholic hepatitis(AH).METHODS: We prospectively assessed 52 patients with AH. Demographic, clinical and laboratory parameters were obtained. MELD-Na and Maddrey DFI were calculated on admission. Short-term mortality was assessed at 30 and 90 d. Receiver operating characteristic curve analysis was performed. RESULTS: Thirty-day and 90-d mortality was 44% and 58%, respectively. In the univariate analysis, sodium levels was associated with mortality at 30 and 90 d(P = 0.001 and P = 0.03). Child stage, encephalopathy, ascites, or types of treatment were not associated with mortality. MELD-Na was the only predictive factor for mortality at 90 d. For 30-d mortality area under the curve(AUC) was 0.763(95%CI: 0.63-0.89) for Maddrey DFI and 0.784 for MELD-Na(95%CI: 0.65-0.91, P = 0.82). For 90-d mortality AUC was 0.685(95%CI: 0.54-0.83) for Maddrey DFI and 0.8710 for MELD-Na(95%CI: 0.76-0.97, P = 0.041). CONCLUSION: AH is associated with high shortterm mortality. Our results show that MELD-Na is a more valuable model than DFI to predict short-term mortality. | Mercedes Amieva-Balmori Scherezada María Isabel Mejia-Loza Roberto Ramos-González Felipe Zamarripa-Dorsey Eli García-Ruiz Nuria Pérez y López Eumir I Juárez-Valdés Adriana López-Luria José María Remes-Troche | 2015 | World Journal of Hepatology2015，7，17： | 2 |
| 12 | Laparoscopic gastrojejunostomy for gastric outlet obstruction in patients with unresectable hepatopancreatobiliary cancers: A personal series and systematic review of the literature显示文摘The major symptoms of advanced hepatopancreaticbiliary cancer are biliary obstruction, pain and gastric outlet obstruction(GOO). For obstructive jaundice, surgical treatment should de consider in recurrent stent complications. The role of surgery for pain relief is marginal nowadays. On the last, there is no consensus for treatment of malignant GOO. Endoscopic duodenal stents are associated with shorter length of stay and faster relief to oral intake with more recurrent symptoms. Surgical gastrojejunostomy shows better long-term results and lower re-intervention rates, but there are limited data about laparoscopic approach. We performed a systematic review of the literature, according PRISMA guidelines, to search for articles on laparoscopic gastrojejunostomy for malignant GOO treatment. We also report our personal series, from 2009 to 2017. A review of the literature suggests that there is no standardized surgical technique either standardized outcomes to report. Most of the studies are case series, so level of evidence is low. Decisionmaking must consider medical condition, nutritional status, quality of life and life expectancy. Evaluation ofthe patient and multidisciplinary expertise are required to select appropriate approach. Given the limited studies and the difficulty to perform prospective controlled trials, no study can answer all the complexities of malignant GOO and more outcome data is needed. | Alba Manuel-Vázquez Raquel Latorre-Fragua Carmen Ramiro-Pérez Aylhin López-Marcano Roberto De la Plaza-Llamas José Manuel Ramia | 2018 | World Journal of Gastroenterology2018，24，18： | 2 |
| 13 | l -Carnitine: An adequate supplement for a multi-targeted anti-wasting therapy in cancer显示文摘 | Sílvia Busquets Roberto Serpe Míriam Toledo Angélica Betancourt Enrica Marmonti Marcel Orpí Fabrizio Pin Eva Capdevila Clelia Madeddu Francisco J. López-Soriano Giovanni Mantovani Antonio Macciò Josep M. Argilés | 2012 | Clinical Nutrition2012，，6： | 2 |
| 14 | Nutrient and heavy metal concentration and distribution in corn, soybean and wheat as affected by different tillage systems in the Argentine Pampas显示文摘 | Raúl S Lavado Claudia A Porcelli Roberto Alvarez | 2001 | Soil & Tillage Research2001，，1： | 2 |
| 15 | A comparative evaluation of microalgae for the degradation of piggery wastewater under photosynthetic oxygenation显示文摘 | Ignacio de Godos Virginia A. Vargas Saúl Blanco María C. García González Roberto Soto Pedro A. García-Encina Eloy Becares Raúl Mu?oz | 2010 | Bioresource Technology2010，，14： | 2 |
| 16 | Bolted Steel Connections: Tests on T Stub Components 显示文摘 | James A S Roberto T L | 2000 | Journal of Structural Engineering2000，，1： | 1 |
| 17 | Organic orchardfloor management systems for apple effect on rootstock perform- ance in the mid western United States 显示文摘 | Darios Roberto J Z Ronald L P Franco W | 2009 | HortScience2009，44，2： | 1 |
| 18 | On the multi-product newsboy problem with two constraints显示文摘 | Abdel-Malek Layek L Montanari Roberto | 2005 | Computer Operation Research2005，32，8： | 1 |
| 19 | Multiplex PCR for Diagnosis of Enteric Infections Associated with Diarrheagenic Escherichia coli 显示文摘 | Roberto V Maricel V Rossana L | 2004 | J Clin Microbiol2004，42，4： | 1 |
| 20 | The Psychometric Properties of the Orthogonal Cultural Identification Scale in Asian Americans显示文摘 | Mona L J Tamara LW Carmen G Linda TG Roberto J V | 2002 | Journal of Multicultural Counseling and Development2002，，30： | 1 |
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