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Morbid Obesity in Diabetes Mellitus Type 2 and Exenatide

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Pharmacology & Pharmacy 2014年第2期5卷 149-152页

作者： Maria Angeles Ibanez gil alfonso lopez Ruiz Alicia Hernandez Torres Ana Belen Hernandez Cascales Pedro Pujante Alarcon Maria Dolores Hellin gil Health Center Mariano Yago YeclaSpain Pharmaceutical Care Research at the University of Granada GranadaSpain Infectious Internal Medicine of the Hospital University Virgen de la Arrixaca MurciaSpain Endocrinology and Nutrition service of the Hospital University Virgen de la Arrixaca MurciaSpain

Worldwide, the prevalence of diabetes and obesity is increasing in recent years in developed countries. The first step of treatment is changes in lifestyle and in case of failure to initiate drug treatment. In our case, the patient with morbid obesity and glucose intolerance to metformin therapy was initiated without achieving weight loss and loss of glycemic control after 6 months of treatment. It was decided to add exenatide as an alternative to bariatric surgery. At the end of the study (12 months), it showed a weight reduction of 20.8% (Table 1), 20.83% BMI, glycosylated hemoglobin decrease of 2 points, and improved the lipid profile. so exenatide may be an acceptable option in the use of patient profile. It would be necessary to seek a new alternative treatment with minimal side effects and less healthcare costs.

关键词： Type 2 Diabetes and Obesity Exenatide

Pleiotropic Effects of GlP-1. Cardiovascular Evidence of Effectiveness

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Pharmacology & Pharmacy 2013年第9期4卷 647-650页

作者： Pedro Pujante Alarcon Ana Belen Hernandez Cascales alfonso lopez Ruiz Maria Angeles Ibanez gil Alicia Hernandez Torres Maria Dolores Hellin gil Endocrinology and Nutrition service of the Hospital University Virgen de la Arrixaca MurciaSpain Pharmaceutical Care Research at the University of Granada GranadaSpain Health Center Mariano Yago YeclaMurciaSpain Infectious Internal Medicine of the Hospital University Virgen de la Arrixaca MurciaSpain

Patients with diabetes are characterized by the development of cardiovascular complications: nephropathy, retinopathy, neuropathy, ischemia or hypertensive etc. Therefore, the cardiovascular involvement is the leading cause of death in patients with Diabetes Mellitus type 2 (DM2). Despite intensive treatment on classical factors of cardiovascular disease (blood pressure levels, lDl cholesterol, etc.), patients with diabetes have a high number of cardiovascular events and the onset and prognosis of these are related to glycemic control parameters, glycosylated hemoglobin (HbA1c). On the other hand, the question of the cardiovascular protective effect of some hypoglycemic treatments has been raised, asking what he has done to know more accurately about the safety and cardiovascular effects of the treatments we have today. The two most important incretin hormones are GIP (gastric inhibitory polypeptide) and GlP-1 (glucagon-like peptide-1). Treatment based on GlP-1 is a novel weapon in T2DM that achieves a reduction in HbA1c with other metabolic effects: weight loss and extra effect in dyslipidemia and blood pressure. In the last years other beneficial actions such a protector effect against myocardium ischemia and other actions in basals were reported. In this article we will try to explain the evidence of GlP-1 treatments and its cardiovascular effects.

关键词： GlP-1 T2DM Myocardium Ischemia

Evolution of Biochemical Effects of Byetta<sup>®</sup>in Type 2 Diabetics with Cardiovascular Risk

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Pharmacology & Pharmacy 2013年第9期4卷 679-683页

作者： alfonso lopez Ruiz Maria Angeles Ibanez gil Pedro Pujante Alarcon Alicia Hernandez Torres Ana Belen Hernandez Cascales Maria Dolores Hellin gil Pharmaceutical Care Research at the University of Granada GranadaSpain Health Center Mariano Yago YeclaMurciaSpain Endocrinology and Nutrition service of the Hospital University Virgen de la Arrixaca MurciaSpain Infectious Internal Medicine of the Hospital University Virgen de la Arrixaca MurciaSpain.

The objective of this study was to examine longitudinally the effects of exenatide on different physical and biochemical markers, evaluated in adult type 2 diabetic patients with cardiovascular risk. Data were recorded from 10 patients who attended the outpatient primary care health center Mariano Iago Yecla, Murcia province, spain in the period of December 2009 to October 2011 and who were treated with Byetta®. Differences were statistically significant (p 0.05) in HbA1c from the third month of treatment, and trends of decrease in body weight from the third week of treatment. There was a significant and better glycemic control. Overall effect was interpreted as a sensitizer drug of the parameters evaluated. Randomized studies are recommended with a minimum follow-up of 2 years, to see if the results are maintained over time.

关键词： Diabetes Mellitus Type 2 Exenatide Cardiovascular Risk

statins and sepsis literature Review

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Pharmacology & Pharmacy 2013年第8期4卷 573-577页

作者： Alicia Hernandez Torres Ana Belen Hernandez Cascales Pedro Pujante Alarcon alfonso lopez Ruiz MariaÁngeles Ibanez gil Maria Dolores Hellin gil Hospital University Virgen de la Arrixaca de Murcia MurciaSpain Hospital University Virgen de la Arrixaca de Murcia MurciaSpain Pharmaceutical Care Research at the University of Granada GranadaSpain Health Center Mariano Yago MurciaSpain

Recent data suggest that, in addition to improving dyslipidemia, statin may reduce the risk of infections and infection-related complications. The aim of this study is to make a review of the literature about the effects of statins on clinically relevant outcomes of patients admitted to the hospital and having an infection and/or sepsis, principally in terms of intensive care unit admissions and related death.

关键词： statins Pravastatin simvastatin sepsis Bacteremia Mortality

Hypertension Unusual Cause

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Pharmacology & Pharmacy 2014年第1期5卷 1-3页

作者： Ana Belen Hernandez Cascales Alicia Hernandez Torres Maria Angeles Ibanez gil Pedro Pujante Alarcon alfonso lopez Ruiz Maria Dolores Hellin gil Juan Mayor Barrancos Endocrinology and Nutrition service Hospital University Virgen de la ArrixacaMurciaSpain Infectious Internal Medicine Hospital University Virgen de la ArrixacaMurciaSpain Health Center Mariano Yago MurciaSpain University of Granada GranadaSpain Roman Alberca Psychiatric Hospital El PalmarSpain

We expose a case of a woman with hypertension and hypokalemia. The differential diagnosis should include primary hyperaldosteronism, diuretics or lazantes intake, secondary hyperaldosteronism. In this patient, additional tests performed show no cause of hormonal disruption and the whole picture is due to a high intake of licorice. Glycyrrhetinic acid, the active component of licorice, inhibits renal IIbeta-hydroxisteroid dehydrogenase. This allows cortisol to stimulate mineralocorticoid receptors. licorice ingestion should be considered in the differential diagnosis of hypertension with hypokalemia.

关键词： licorice Glycyrrhizic Acid Glycyrrhizinic Acid Induced Hypertension Hypokalemia

Review: surgical Treatment of Type 2 Diabetes

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Pharmacology & Pharmacy 2014年第1期5卷 24-29页

作者： Maria Dolores Hellin gil Pedro Pujante Alarcon alfonso lopez Ruiz Maria Angeles Ibanez Alicia Hernandez Torres Ana Belen Hernandez Cascales Nutrition service Hospital University Virgen de la Arrixaca de MurciaMurciaSpain Endocrinology and Nutrition service Hos-pital University Virgen de la Arrixaca de MurciaMurciaSpain Community Pharmacy Bullas(Murcia)Spain Health Center Mar-iano Yago Yecla(Murcia)Spain Infectious Internal Medicine Hospital University Virgen de la Arrixaca de MurciaMurciaSpain

In the last decades we have witnessed a significant increase in the incidence of type 2 diabetes mellitus, and obesity in parallel. so 90% of patients with Diabetes Mellitus type 2 (DM2) are obese. Changes in lifestyle (diet and exercise), behavioral therapies or the use of certain anti-obesity drugs have shown a limited effect and are not maintained over time. Currently, bariatric surgery is the most effective anti-obesity treatment, which is durable and resolves associated comorbidities. The surgical treatment of obesity for the modification of the anatomy of the digestive system is to produce gastric capacity constraints alone or associate with varying degrees of intestinal malabsorption and reduce body weight, improve and maintain the comorbidities associated weight loss by reduced food intake alone or in combination with malabsorption of this. The development of these surgical techniques has occurred in stages. With these techniques, setting to bariatric surgery is an effective, safe and proven procedure for the treatment of obesity and its complications especially DM2, as their post surgery referral mechanisms provide us with information for potential therapeutic treatment aimed at optimizing the control DM2 patients metabolic obese. In this review, we expose the evidence in treatment of DM2 with bariatric surgery and the actual hypothesis trying to explain how it is possible.

关键词： DM2 Bariatric surgery Gastric Bypass

Case series of 11 Patients Operated with Axial-lIF Technique in a single Center in Mexico

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Open Journal of Modern Neurosurgery 2023年第3期13卷 129-136页

作者： alfonso Vega sosa sergio Ivan Reyna Heredia Apolinar De la luz laguna Ivanka Berenice Moreno Villa Marlene de la Peña Gutiérrez Ramiro lópez Elizalde Cuauhtémoc gil Ortiz Andres Jaime Aguirre Ivan Alejandro Mendez Guerrero Edwin Rolando sanchez Vallejo Alejandra Grisel Mendoza Zuñiga Ricardo Cazares Mejía Carlos Erosa Velázquez Universidad Nacional Autónoma de México Mexico City Mexico Centro Medico Nacional 20 de Noviembre Mexico City Mexico Centro Médico Naval Mexico City Mexico

Introduction: since the earliest description of spinal fusion in 1911 and later by Dr. Fred H. Albee, it has become one of the most commonly performed procedures by orthopedist and neurosurgeons. The spinal fusion is now used to treat a variety of indications, such as traumatic injuries, deformities, primary and secondary tumors, infections and degenerative conditions of the spine. The risk of iatrogenic injury during traditional anterior, posterior, and transforaminal open fusion surgery is significant. The axial lumbar interbody fusion (Axia-lIF) is a minimal invasive technique which uses the retroperitoneumpresacral anatomical corridor to fuse the lumbar vertebral bodies l4-l5-s1 avoiding manipulation of the annular ligament, paravertebral muscles and facet joints. Methods: In this retrospective series, we report all the cases made in the Centro Medico Naval in México City in two years. A total of eleven patients with degenerative disc disease and spondylolisthesis underwent Axia-lIF one or two level systems with a 36 months clinical and radiographic follow-up. The outcomes included Oswestry Disability Index (ODI) score and leg/back pain severity. Radiographic outcome was evaluated with dynamics and orthogonal x-ray, as well as lumbosacral tomography scan to evaluate fusion status. Results: Nine patients underwent Axia-lIF one level system (l5-s1) and the rest two levels system (l4-s1). Ten patients were fixated with transpedicular percutaneous screws and one with facets joints screws. No intraoperative complications were reported. The mean back pain severity improved 57% in 12 months, and the mean leg pain severity improved 50% in the same time (P scores improved 58%, from 60% ± 16% at baseline to 25% ± 8% at twelve months (P loped pseudoarthrosis that required posterolateral arthrodesis with transpedicular percutaneous screws. At 36 months monitoring, 100% patients presented a total interbody fusion in the

关键词： spine surgery Axial-lIF Procedure Axial-lIF CMN 20 de Noviembre spinal Fusion Centro Médico Naval

16世纪伊比利亚人征服美洲空间的初始解释和理由

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世界近现代史研究 2022年第2期 97-113,349页

作者： [委内瑞拉]卡洛斯·阿方索·弗朗哥·希尔姜玉妍(译) 委内瑞拉国家历史中心南开大学世界近现代史研究中心和拉丁美洲研究中心

16世纪的美洲征服是从历史上理解欧洲文明和本土文明碰撞之后国家、社会和文化建设的关键之一。在殖民阶段,这些文明逐渐转变,以巩固美洲人的各种观点,在17世纪西班牙和葡萄牙人统治的大陆地区,这些观点将大放异彩。正是出于这个原因,... 详细信息

16世纪的美洲征服是从历史上理解欧洲文明和本土文明碰撞之后国家、社会和文化建设的关键之一。在殖民阶段,这些文明逐渐转变,以巩固美洲人的各种观点,在17世纪西班牙和葡萄牙人统治的大陆地区,这些观点将大放异彩。正是出于这个原因,我们基于文化史中的理论和方法工具,准备通过文献和史学资源,分析前美洲想象的破裂过程,包括后来被称为美洲的欧洲—伊比利亚社会和前哥伦布社会,认识到征服过程的正当理由来自中世纪的欧洲想象和哲学,这些想象和哲学由于面临16世纪西方的伊比利亚基督徒所不知道的人类和自然现实而被迫逐渐改变,新的人类和自然现实颠覆了既定的想法,并培养了在殖民阶段将要形成的新场景的形式。

关键词：美洲史美洲征服文化史异质性