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Management of biliary complications after orthotopic liver transplantation:The role of endoscopy

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World Journal of Gastroenterology 2008年第4期14卷 493-497页

作者： Maria c Londoo Domingo Balderramo andrés cárdenas GI Unit Institut de Malalties Digestives i MetaboliquesUniversity of BarcelonaHospital ClínicBarcelona 08036Spain

Biliary complications are signifi cant causes of morbidity and mortality after orthotopic liver transplantation (OLT). The estimated incidence of biliary complications after OLT ranges between 10%-25%,however,these numbers continue to decline due to improvement in surgical techniques. The most common biliary complications are strictures (both anastomotic and non-anastomotic) and bile leaks. Most of these problems can be appropriately managed with endoscopic retrograde colangiography (ERc). Other complications such as bile duct stones,bile casts,sphincter of Oddi dysfunction,and hemobilia,are less frequent and also can be managed with ERc. This article will review the risk factors,diagnosis,and endoscopic management of the most common biliary complications after OLT.

关键词：肝同位移植胆汁渗透并发症症状

Hemodialysis in Pregnant with systemic Lupus Erythematosus: case Report and Review

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Open Journal of Nephrology 2022年第1期12卷 48-59页

作者： José Lucas Daza Yaroslad de la cruz John Fredy Galindo Luis Puello Gerardo Gutiérrez María camila correcha carlos Alban Daniel soto andrés cárdenas Luis José Daza Néstor Guarnizo Abel caraballo Internist-Nephrologist Ibague Colombia Internist-Nephrologist Cali Colombia General Physician Ibague Colombia Internist-Nephrologist cartagena Colombia Internist-Nephrologist Villavicencio Colombia Medical student Santa Marta Colombia Internist-Hematologist Cartagena Colombia General Physician University of Tolima Ibague Intensivist Phsysician Barranquilla Colombia

systemic lupus erythematosus is an autoimmune disease with an etiopathogenesis that is still unclear. With a higher incidence in women of childbearing age. Pregnancy in patients suffering from this pathology is a constant challenge for multidisciplinary teams. The changes of pregnancy, especially to the immune system and the kidney, have repercussions on the renal compromise secondary to lupus. Lupus nephropathy is more active during pregnancy and leads to adverse outcomes for the mother-fetus binomial. The early identification of pregnant women with a higher risk of complications, access to health resources and the participation of a multidisciplinary team is the strategy that increases maternal-fetal survival. A report case of a 25-year-old black female with sLE and a 10-week pregnancy who was admitted to the emergency department with criteria for dialysis. The literature focused on lupus nephritis and dialysis in pregnancy was reviewed. Articles were reviewed in databases such as PubMed, cochrane, among others, focused on the topic of pregnancy with sLE and pregnancy with dialysis. A total of 15 review articles, 2 meta-analyses, 3 observational studies and 6 cohort studies (3 prospective and 3 retrospective) were filtered.

关键词： Dialysis Lupus Nephritis Pregnancy Renal Disease and systemic Lupus Erythematous

基于罗马Ⅳ标准的肝移植患者胆管括约肌疾病的发生率和临床结局

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Gastroenterology Report 2021年第4期9卷 299-305,I0001页

作者： Alejandro Fernandez-simon Oriol sendino Karina chavez-Rivera Henry córdova Jordi colmenero Gonzalo crespo Yilliam Fundora Franco samaniego Pablo Ruiz constantino Fondevila Miquel Navasa andrés cárdenas GI Unit Institut Clı´nic de Malalties Digestives i MetaboliquesHospital Clı´nicUniversity of BarcelonaBarcelonaSpain Institut d’Investigacions Biomèdiques August Pi-sunyer(IDIBAPs)and ciber de Enfermedades Hepáticas y Digestivas(cIBEREHD) BarcelonaSpain Liver Transplant Unit Institut Clínic de Malalties Digestives i MetabóliquesHospital ClínicUniversity of BarcelonaBarcelonaSpain

背景:目前对肝移植患者胆管括约肌疾病的认识严重不足。本研究旨在描述基于最新修订的罗马Ⅳ标准,肝移植患者乳头狭窄(Ps)和胆管括约肌功能障碍(FBsD)的发生率和临床结局。方法:筛选2003年1月至2019年12月间接受内镜逆行性胆胰管造影(ER... 详细信息

背景:目前对肝移植患者胆管括约肌疾病的认识严重不足。本研究旨在描述基于最新修订的罗马Ⅳ标准,肝移植患者乳头狭窄(Ps)和胆管括约肌功能障碍(FBsD)的发生率和临床结局。方法:筛选2003年1月至2019年12月间接受内镜逆行性胆胰管造影(ERcP)的肝移植患者,从电子病历和内镜数据库中提取其临床资料及内镜发现,并收集ERcP检查时及ERcP术后1个月的实验室检查结果和临床结局。结果:在1,307例肝移植患者中,336例接受了849次ERcP。13例(1.0%)符合罗马Ⅳ的Ps诊断标准[既往称为Oddi括约肌功能障碍(ODs)Ⅰ型],14例(1.0%)符合FBsD诊断标准(既往称为sOD Ⅱ型)。13例Ps患者和10例FBsD患者接受了胆管狭窄成形术,术后1个月,分别有85%、61%和92%的Ps患者总胆红素(P=0.019)、γ谷氨酰转移酶(P=0.087)和碱性磷酸酶(P=0.003)下降,而在FBsD患者,上述指标下降的患者比例分别为50%(P=0.721)、70%(P=0.013)和80%(P=0.093)。所有最初疑似BFsD的14例患者在随访中均调整了最终诊断。结论:肝移植术后Ps的发生并不常见,发生率仅1%。我们的数据并不支持肝移植术后FBsD的诊断。狭窄成形术治疗肝移植术后Ps患者安全有效。

关键词：肝移植患者临床结局 γ谷氨酰转移酶肝移植术后乳头狭窄胆管括约肌胆管狭窄诊断标准

Posterior quadrant epilepsy surgery: case series of a south American hospital

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Acta Epileptologica 2022年第4期5卷 227-232页

作者： Mario Velasco andrés Felipe cárdenas-cruz María Paula Aguilera-Pena Alejandro Vargas-Moreno Daniel Nariño Juan carlos Pérez Oscar Zorro Pontificia Universidad Javeriana Cr16#75-32 apt 203BogotaColombia110221 Neuroscience Department Hospital Universitario San IgnacioCr16#75-32 apt 203BogotaColombia110221

Background Posterior quadrant epilepsy(PcE)is a type of focal epilepsy that originates in the parietal lobe,occipital lobe,and the parietal-occipital border of the temporal lobe,or in any combination of these regions.PcE has a low incidence,but it can cause a great burden in disability-adjusted life years.In this retrospective cohort,patients of all ages with a diagnosis of PcE between 2006 and 2019 were evaluated in a referral center in Bogotá,colombia.A descriptive analysis of demographic data,clinical history,imaging findings,type of surgery,histopathological diagnosis,outcome,and follow-up was performed using the Engel scale.Methods This study included refractory PcE patients of all ages who were evaluated by the epilepsy surgery group of the Hospital Universitario san Ignacio from 2006 to 2019.clinical,imaging and surgical variables were obtained from the medical records and analyzed.Results Thirteen patients were included in the study,including 8 males and 5 females.The mean age of diagnosis was 8.8 years,while the mean age of surgery was 25 years.The most frequent clinical finding was intellectual disability.The most common findings on magnetic resonance imaging were encephalomalacia and gliosis.In 61.5%of the patients,the lateralization of video-EEG matched with brain magnetic resonance imaging alteration.The most frequent types of surgery performed were lobectomies,lesionectomies and cortical resections.seizure-freedom was achieved in approximately one third of the patients;however,more than half of the patients were free of disabling seizures or had significant improvement after surgery.conclusions PcE surgery is scarcely performed worldwide,therefore the effectiveness and outcomes are quite variable in the reported literature.In this study,we show that patients with PcE can obtain great benefits in terms of reduction of seizures with a low risk of surgical complications,encouraging the use of this type of procedure in carefully selected patients.

关键词： Posterior cortex Epilepsy surgery Posterior quadrant epilepsy

Elevation transition of aquatic insects closely matches a thermal feature in the Yungas of Northwestern Argentina

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Journal of Mountain science 2024年第2期21卷 433-448页

作者： Alexandra BUITRAGO-GUAcANAME carlos MOLINERI andrés LIRA-NORIEGA Daniel andrés DOs sANTOs Neotropical Biodiversity Institute(cONIcET-UNT) UNT-DomesHorco Molle S/N4107 TucumánArgentina cONAcYT Research Fellow Network of Advanced Molecular StudiesInstitute of Ecology A.COld Road to Coatepec 351El HayaCP 91073XalapaVeracruzMexico Biostatistics chair Faculty of Natural Sciences and IMLNational University of TucumánSan Miguel de TucumánMiguel Lillo 2054000 TucumánArgentina

Temperature is a key factor that shapes the distribution of organisms.Having knowledge about how species respond to temperature is relevant to devise strategies for addressing the impacts of climate change.Aquatic insects are particularly vulnerable to climate change,yet there is still much to learn about their ecology and distribution.In the Yungas ecoregion of Northwestern Argentina,cold-and warm-adapted species of the orders Ephemeroptera,Plecoptera,and Trichoptera(EPT)are segregated by elevation.We modeled the ecological niche of south American EPT species in this region using available data and projected their potential distribution in geographic space.species were grouped based on their ecogeographic similarity,and we analyzed their replacement pattern along elevation gradients,focusing on the ecotone where opposing thermal preferences converge.Along this interface,we identified critical points where the combined incidence of cold and warm assemblages maximizes,indicating a significant transition zone.We found that the Montane cloud Forest holds the interface,with a particularly greater suitability at its lower boundary.The main axis of the interface runs in a N-s direction and falls between 14°c-16°c mean annual isotherms.The probability of a particular location within a basin being classified as part of the interface increases as Kira’s warmth index approaches a score around 150.Understanding the interface is critical for defining the thermal limits of species distribution and designing biomonitoring programs.changes in the location of thermal constants related to mountainous ecotones may cause vertical displacement of aquatic insects and vegetation communities.We have recognized significant temperature thresholds that serve as indicators of suitability for the interface.As global warming is anticipated to shift these indicators,we suggest using them to monitor the imprints of climate change on mountain ecosystems.

关键词： Austral Yungas Ecological Niche Model Ephemeroptera Kira’s warmth index Plecoptera Trichoptera

Virtual Transmission solution Based on Battery Energy storage systems to Boost Transmission capacity

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Journal of Modern Power systems and clean Energy 2024年第2期12卷 466-474页

作者： Matías Agüero Jaime Peralta Eugenio Quintana Victor Velar Anton stepanov Hossein Ashourian Jean Mahseredjian Roberto cárdenas coordinador Eléctrico Nacional SantiagoChile PGsTech Montreal Canada Ecole Polytechnique de Montréal Montréal Canada University of chile Santiago Chile IEEE

The increasing penetration of variable renewable energy(VRE)generation along with the decommissioning of conventional power plants in chile,has raised several operational challenges in the chilean National Power Grid(NPG),including transmission congestion and VRE curtailment.To mitigate these limitations,an innovative virtual transmission solution based on battery energy storage systems(BEsss),known as grid booster(GB),has been proposed to increase the capacity of the main 500 kV corridor of the NPG.This paper analyzes the dynamic performance of the GB using a wide-area electromagnetic transient(EMT)model of the NPG.The GB project,composed of two 500 MVA BEss units at each extreme of the 500 kV corridor,allows increasing the transmission capacity for 15 min during N-1 contingencies,overcoming transmission limitations under normal operation conditions while maintaining system stability during faults.The dynamic behavior of the GB is also analyzed to control power flow as well as voltage stability.The results show that the GB is an effective solution to allow greater penetration of VRE generation while maintaining system stability in the NPG.

关键词： Battery energy storage system(BEss) grid booster transient stability voltage stability electromagnetic transient(EMT)

A modular microfluidic platform to study how fluid shear stress alters estrogen receptor phenotype in ER+breast cancer cells

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Microsystems & Nanoengineering 2024年第1期10卷 287-299页

作者： Braulio andrés Ortega Quesada Jonathan cuccia Rachael coates Blake Nassar Ethan Littlefield Elizabeth c.Martin Adam T.Melvin cain Department of chemical Engineering Louisiana State UniversityBaton RougeLA 70803USA Department of chemical and Biological Engineering Clemson UniversityClemsonSC 29634USA Biological and Agricultural Engineering Louisiana State UniversityBaton RougeLA 70803USA Department Medicine Section Hematology and Medical OncologyTulane UniversityNew OrleansLA 70118USA

Metastatic breast cancer leads to poor prognoses and worse outcomes in patients due to its invasive behavior and poor response to therapy.It is still unclear what biophysical and biochemical factors drive this more aggressive phenotype in metastatic cancer;however recent studies have suggested that exposure to fluid shear stress in the vasculature could cause this.In this study a modular microfluidic platform capable of mimicking the magnitude of fluid shear stress(Fss)found in human vasculature was designed and fabricated.This device provides a platform to evaluate the effects of Fss on McF-7 cell line,an estrogen receptor positive(ER+)breast cancer cell line,during circulation in the vessels.Elucidation of the effects of Fss on McF-7 cells was carried out utilizing two approaches:single cell analysis and bulk analysis.For single cell analysis,cells were trapped in a microarray after exiting the serpentine channel and followed by immunostaining on the device(on-chip).Bulk analysis was performed after cells were collected in a microtube at the outlet of the microfluidic serpentine channel for western blotting(off-chip).It was found that cells exposed to an Fss magnitude of 10 dyn/cm^(2) with a residence time of 60 s enhanced expression of the proliferation marker Ki67 in the McF-7 cell line at a single cell level.To understand possible mechanisms for enhanced Ki67 expression,on-chip and off-chip analyses were performed for pro-growth and survival pathways ERK,AKT,and JAK/sTAT.Results demonstrated that after shearing the cells phosphorylation of p-AKT,p-mTOR,and p-sTAT3 were observed.However,there was no change in p-ERK1/2.AKT is a mediator of ER rapid signaling,analysis of phosphorylated ERαwas carried out and no significant differences between sheared and non-sheared populations were observed.Taken together these results demonstrate that Fss can increase phosphorylation of proteins associated with a more aggressive phenotype in circulating cancer cells.These findings provide additional information that may help

关键词： fluid breast estrogen

New immune regulators of sciatic nerve regeneration?Lessons from the neighborhood

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Neural Regeneration Research 2024年第4期19卷 705-706页

作者： andréL.Bombeiro Rodrigo G.Q.Fernandes Julie c.Ribot Instituto de Medicina Molecular João Lobo Antunes Faculdade de MedicinaUniversidade de LisboaLisbonPortugal

For decades,the immune system has been associated with host protection against infectious pathogens or tumors,while also contributing to autoimmunity.Notwithstanding,this paradigm is now changing,with recent studies highlighting novel roles for immune mediators in the maintenance of steady-state tissue homeostasis.In this perspective,we review some of the latest findings featuring immune modulators of the nervous system pathophysiology,with a special focus on interleukin(IL)-17.

关键词： homeostasis neighborhood finding

Metabolomics for the diagnosis of bladder cancer: A systematic review

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Asian Journal of Urology 2024年第2期11卷 221-241页

作者： Herney andrés García-Perdomo Angélica María Dávila-Raigoza Fernando Korkes Division of Urology/Urooncology Department of SurgerySchool of MedicineUniversidad del ValleCaliColombia UROGIV Research Group School of MedicineUniversidad del ValleCaliColombia Urologic Oncology Division of UrologyABC Medical SchoolSao PauloBrazil

Objective: Metabolomics has been extensively utilized in bladder cancer (Bca) research, employing mass spectrometry and nuclear magnetic resonance spectroscopy to compare various variables (tissues, serum, blood, and urine). This study aimed to identify potential biomarkers for early Bca diagnosis.Methods: A search strategy was designed to identify clinical trials, descriptive and analytical observational studies from databases such as Medline, Embase, cochrane central Register of controlled Trials, and Latin American and caribbean Literature in Health sciences. Inclusion criteria comprised studies involving Bca tissue, serum, blood, or urine profiling using widely adopted metabolomics techniques like mass spectrometry and nuclear magnetic resonance. Primary outcomes included description of metabolites and metabolomics profiling in Bca patients and the association of metabolites and metabolomics profiling with Bca diagnosis compared to control patients. The risk of bias was assessed using the Quality Assessment of studies of Diagnostic Accuracy.Results: The search strategy yielded 2832 studies, of which 30 case-control studies were included. Urine was predominantly used as the primary sample for metabolite identification. Risk of bias was often unclear inpatient selection, blinding of the index test, and reference standard assessment, but no applicability concerns were observed. Metabolites and metabolomics profiles associated with Bca diagnosis were identified in glucose, amino acids, nucleotides, lipids, and aldehydes metabolism.conclusion: The identified metabolites in urine included citric acid, valine, tryptophan, taurine, aspartic acid, uridine, ribose, phosphocholine, and carnitine. Tissue samples exhibited elevated levels of lactic acid, amino acids, and lipids. consistent findings across tissue, urine, and serum samples revealed downregulation of citric acid and upregulation of lactic acid, valine, tryptophan, taurine, glutamine, aspartic acid, uridine, ribose, and phosphocholine.

关键词： Metabolite Metabolomics Bladder cancer Metabolomicsprofile