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Neuromodulation and ablation with focused ultrasound-toward the future of noninvasive brain therapy

Neural Regeneration Research 2019年第9期14卷 1509-1510页

作者： Anton Fomenko andres m.lozano Krembil Research Institute University Health NetworkTorontoCanada Division of Neurosurgery Toronto Western HospitalTorontoCanada

With an aging patient population and an increased burden of neurological disease,the demand for noninvasive alternatives to open neurosurgical procedures is *** or minimally invasive approaches to targeting brain regions include transcranial magnetic stimulation(TmS),transcranial direct current stimulation,temporally interfering electric fields,and focused ultrasound(FUS).Among these modalities,FUS offers a unique combination of target specificity,deep brain penetration,and compatibility with real-time structural and thermal monitoring using magnetic resonance imaging(mRI)and mR *** on the intensity and frequency used,ultrasound can have either modulating or ablative effects on brain ***-intensity mR-guided FUS(mRgFUS)is a noninvasive and effective alternative to conventional deep-brain stimulation and radiofrequency lesioning for essential tremor(ET),and is being investigated for other movement disorders,particularly Parkinson’s *** clinical implementation of high-intensity ultrasound is challenged by limitations in target selection precision,technical barriers(such as variable penetration and heat deposition)and the possibility of lesion-related adverse effects(Schwartz et al.,2018).Emerging studies,including those from our group(Boutet et al.,2018)are striving to refine targeting of mRgFUS to improve safety and patient clinical *** the same time,low-intensity FUS(LIFUS)has been found to safely modulate brain activity in rodents,primates,and healthy human subjects(Fomenko et al.,2018).Clinical translation of LIFUS has been hampered however,by a poor understanding of the mechanisms of action,uncertainty over effective sonication parameters and intensities,and conflicting study results due to heterogeneous experimental *** this perspective,the current state of both mRgFUS ablation and LIFUS neuromodulation will be *** technical challenges to delivering ultrasound to the brain,recen

关键词： precision procedures Parkinson human same FUS can has

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Current surgical treatments for Parkinson's disease and potential therapeutic targets

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Neural Regeneration Research 2018年第8期13卷 1342-1345页

作者： Darrin J.Lee Robert F.Dallapiazza Philippe De Vloo andres m.lozano Division of Neurosurgery Toronto Western Hospital Department of Surgery University of Toronto

Currently, the most common surgical treatment for Parkinson＇s disease is deep brain stimulation（DBS）. This treatment strategy is typically reserved for bradykinesia, rigidity and tremor in patients who no longer respond to medication in a predictable manner or who suffer medication-induced dyskinesias. In addition to DBS, ablative procedures like radiofrequency, radiosurgery and focused ultrasound are also utilized for select tremor symptoms. In this review, we discuss evolving surgical techniques, targets, and emerging technology. In addition, we evaluate potential paradigm shifts in treatment, including gene therapy, immunotherapy and cell transplantation. While these new techniques and treatment options are still in their infancy, advances in Parkinson＇s disease treatment are rapidly expanding.

关键词： Parkinson's disease deep brain stimulation pallidotomy thalamotomy focused ultrasound gene therapy immunotherapy cell transplantation

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Hepatic rupture secondary to HELLP syndrome: outcomes in three cases

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World Journal of Emergency medicine 2024年第1期15卷 56-58页

作者： Salvador Gomez-Carro Ruben R.lozano-Salazar Kassandra Santos-Zaldívar Victor andres Villasuso-Alcocer Nina méndez-Domínguez O'Horan General Hospital Merida 97000Mexico Highly Specialized Hospital of the Yucatan Peninsula Merida 97134Mexico National Institute of Perinatology.mexico City 11000 Mexico

Hypertensive disorders of pregnancy,including chronic hypertension,gestational hypertension,and preeclampsia,are the most common complications in pregnant women,affecting approximately 15%of pregnancies.[1,2]Hemolysis,elevated liver enzymes,and low platelet count(HELLP syndrome)can occur in 0.2%-0.6%of all pregnancies,and 10%-15%of patients are diagnosed with preeclampsia.[3,4]Among its severe complications,liver hematoma is remarkable and may lead to liver *** identification of HELLP syndrome is crucial for proper therapeutic management and to avoid fatal outcomes[4,5]since when a hepatic hematoma occurs,the risk of rupture increases to 12%.[3,5]

关键词： rupture HELLP hypertension pregnancy

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Fetkin-hydro,a new thermo-hydrological algorithm for low-temperature thermochronological modeling

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Geoscience Frontiers 2021年第3期12卷 186-200页

作者： Francisco Sánchez andres Barrea Federico m.Dávila andres mora Centro de Investigaciones en Ciencias de la Tierra(CICTERRA) CONICET-UNCFCEFyNCiudad UniversitariaAv.Vélez Sarsfield 16115000 CórdobaArgentina Facultad de matemática AstronomíaFísica y Computación(FAMAF)Ciudad UniversitariaAv.Medida Allende 21445000 CórdobaArgentina Ecopetrol BotafogoRio de JaneiroBrazil

Despite two decades of major advances in the field of thermochronological modeling,state-of-the-art numerical implementations still rely mostly on burial and exhumation processes to explain radiometric *** though such an approach has proved valuable,failing to account for other first-order geological variables has led to misinterpretations and therefore,calls for a *** this study a new version of the Fetkin(finite element temperature kinematics,Ecopetrol)program is *** new algorithm couples time-dependent hydrological and thermal calculations,thus rendering thermochronological ages that,instead of being solely dependent on the kinematical evolution of a system,conditioning by the fluid flow is also *** contrast with previous thermochronological models,this work considers the influence of effective stress on rock properties(porosity and permeability)and therefore,in thermal *** analyses addressing relevant geological questions show not only the versatility of the code but also,new perspectives on forward low-temperature thermochronological *** circulation through pure-sandstone settings produce colder thermal architectures than those obtained in impermeable *** in cooling ages from models with and without fluid circulation are up to 5 myr.A 4-fold variation in thrusting rates(0.5 km/myr to 2 km/myr)produces a 15-myr difference in cooling ages in models with fluid flow,which contrasts to much lower differences,only 2 myr,in domains without(or minimal)fluid circulation.2D thermal solutions in fold-bend-fold thrust belts composed of sandstones remain static despite substantial relief development by kinematic folding.A case-study from Western Argentina,in the Andean Precordillera,confirms the plausibility of the numerical algorithm here posed and raises new questions on the first-order thermal controls in settings under deformation.

关键词： Thermochronology Hydrogeology Fluid flow Numerical modeling

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帕金森病研究新进展

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科学（中文版） 2005年第9期 58-65页

作者： andres m.lozano Suneil K.Kalia 蒋青伟多伦多西部医院

帕金森病,最早在19世纪初被英国内科医生James Parkinson描述为"震颤麻痹",是最常见的神经系统疾病之一.

关键词：帕金森病细胞学遗传学

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Challenges and improvement strategies in the hospitalization of chronic multimorbid patients

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World Journal of Clinical Cases 2025年第3期13卷 35-41页

作者： andres Fontalba-Navas Francisco Pozo muñoz Rogelio Garcia Cisneros maria Jose Garcia Larrosa maria del mar Callejon Gil Ignacio Garcia Delgado maria Belen Jimenez martinez Antequera Hospital Northern Málaga Integrated Healthcare AreaAntequera 29200AndalusiaSpain Department of Public Health and Psychiatry University of MálagaMálaga 29010Spain Antequera Hospital Northern Málaga Antequera Integrated Healthcare AreaAntequera 29200MálagaSpain

BACKGROUND Addressing the growing challenge of hospitalizing chronic multimorbid patients,this study examines the strain these conditions impose on healthcare systems at a local level,focusing on a pilot *** diseases and complex patients require comprehensive management strategies to reduce healthcare burdens and improve patient *** proven effective,this pilot model has the potential to be replicated in other healthcare settings to enhance the management of chronic multimorbid *** To evaluate the effectiveness of the high complexity unit(HCU)in managing chronic multimorbid patients through a multidisciplinary care model and to compare it with standard hospital *** The study employed a descriptive longitudinal approach,analyzing data from the Basic minimum Data Set(BmDS)to compare hospitalization variables among the HCU,the Internal medicine Service,and other services at Antequera Hospital throughout *** HCU,designed for patients with complex chronic conditions,integrates a patient-centered model emphasizing multidisciplinary care and continuity *** The study employed a descriptive longitudinal approach,analyzing data from the BmDS to compare hospitalization variables among the HCU,the Internal medicine Service,and other services at Antequera Hospital throughout *** HCU,designed for patients with complex chronic conditions,integrates a patient-centered model emphasizing multidisciplinary care and continuity *** This study demonstrates the effectiveness of the HCU in managing patients with complex chronic diseases through a multidisciplinary *** coordinated care provided by the HCU results in improved patient outcomes,reduced unnecessary hospitalizations,and better management of patient *** superiority of the HCU compared to standard care is evident in key outcomes such as fewer readmissions and higher patient satisfaction,reinforcing its value as a model of ca

关键词： High complexity unit Chronic multimorbidity Patient-centered care Integrated care Healthcare management

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Adaptive Control for Passive Kinesiotherapy ELLTIO

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Journal of Bionic Engineering 2014年第4期11卷 581-588页

作者： Ricardo López Hipólito Aguilar Sergio Salazar Rogelio lozano Laboratory UmI LAFmIA 3175 CINVESTAV-CNRS Móxico D. F. CNRS Research Director Universitb de Technologie de Compiègne 60200 Compiègne France

Exoskeletons are mechatronic devices used to increase human muscle strength and resistance. In the last decade these devices have become a very useful tool to assist active kinesiotherapy. This paper presents the design of exoskeleton focused on the rehabilitation of ankle and knee for the right leg. The construction of prototype like Exoskeleton for Lower Limb Training with Instrumented Orthoses （ELLTIO） using Series Elastic Actuator （SEA） to reduce the effort in the human joints, and a control law to perform a rehabilitation routine using an adaptive control scheme were first implemented in simulation to verify the control strategy and make a real rehabilitation test. The adaptive control law is proposed with the intention that the exoskeleton can adapt to user parameters at the time when performing the exercise. The results show the parameters estimation and tracking trajectory for the exoskeleton were proposed, and this trajectory could be a routine rehabilitation proposed by the therapist.

关键词： exoskeleton parametric identification rehabilitation robotics adaptive control.

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A valve-in-valve approach to manage severe bioprosthetic tricuspid valve stenosis

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Journal of Geriatric Cardiology 2021年第5期18卷 400-402页

作者： Dominika m Zoltowska Naji maaliki Bashar Al-Turk andres m Pineda maldonado Srinivasan Sattiraju Cardiology University of Florida College of Medicine-JacksonvilleFloridaUSA Internal medicine University of Florida College of Medicine-JacksonvilleFloridaUSA

severe symptomatic tricuspid stenosis often requires *** the etiology is bioprosthetic valve failure,a challenging situation is *** valve replacement is the gold standard of treatment for severe tricuspid valve(TV)disease.[1]However,a redo sternotomy is rarely performed for isolated TV disease due to very high perioperative mortality.[2]Evolving percutaneous technology presents new frontiers in treatment,with the valveinvalve procedure emerging as an *** present a case of a 65year woman with progressive symptoms due to failure of a bioprosthetic valve in the tricuspid position who was not a surgical candidate but underwent percutaneous intervention with significant clinical improvement.

关键词： tricuspid stenosis mortality

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Effect of treatment failure on the Cag A EPIYA motif in Helicobacter pylori strains from Colombian subjects

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World Journal of Gastroenterology 2017年第11期23卷 1980-1989页

作者： Javier andres Bustamante-Rengifo andres Jenuer matta Alvaro Jairo Pazos Luis Eduardo Bravo Department of microbiology School of Basic ScienceUniversidad del Valle Registro Poblacional de Cáncer de Cali Department of PathologySchool of MedicineUniversidad del Valle Department of Biology Universidad de Narino

AIm To evaluate effect of treatment failure on cag A and vac A genotypes in Helicobacter pylori(H. pylori) isolates from *** One hundred and seventy-six participants infected with H. pylori from Colombia were treated during 14 d with the triple-standard therapy. Six weeks later, eradication was evaluated by 13C-Urea breath test. Patients with treatment failure were subjected to endoscopy control; biopsies obtained were used for histopathology and culture. DNA from H. pylori isolates was amplified using primers specific for cag A and vac A genes. The phylogenetic relationships among isolates obtained before and after treatment were established by conglomerate analysis based on random amplified polymorphic DNA(RAPD) *** Treatment effectiveness was at 74.6%. Of the par-ticipants with treatment failure, 25 accepted subjected to a second endoscopy. Prevalence of posttreatment infection was 64%(16/25) and 40%(10/25) by histology and culture, respectively. Upon comparing the cag A and vac A genotypes found before and after therapy, multiple cag A genotypes(cag A-positive and cag A-negative) were found before treatment; in contrast, cag A-negative genotypes decreased after treatment. vac A s1m1 genotype was highly prevalent in patients before and after therapy. The 3'cag A region was successfully amplified in 95.5%(21/22) of the isolates obtained before and in 81.8%(18/22) of the isolates obtained after treatment. In the isolates obtained from patients with treatment failure, it was found that 72.7%(16/22) presented alterations in the number of EPIYA motifs, compared to isolates found before *** Unsuccessful treatment limits colonization by lowvirulence strains resulting in partial and selective eradication in mixed infections, and acts on the cag A-positive strains inducing genetic rearrangements in cag A variable region that produces a loss or gain of EPIYA repetitions.

关键词： Helicobacter pylori RAPD-PCR Treatment failure EPIYA motifs 3’ cag A variable region

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NHC-catalysed[3+2]-asymmetric annulation between pyrazolin-4,5-diones and enals:synthesis of novel spirocyclic pyrazolone γ-butyrolactones and computational study of mechanism and stereoselectivity

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Organic Chemistry Frontiers 2022年第2期9卷 420-427页

作者： marta Gil-Ordonez Alicia maestro Pablo Ortega Pablo G.Jambrina Jose m.andres GIR-SintACat-Instituto Universitario CINQUImA y Departamento de Química Orgánica Facultad de CienciasUniversidad de ValladolidPaseo Belén 747011 ValladolidSpain Departamento de Química Física University of Salamanca37008 SalamancaSpain

Chiral pyrazolones with a spirocyclic centre at the C4-position are widely found in a large family of medically relevant *** recent years,organocatalysis,particularly that performed with quiral N-heterocyclic carbenes(NHCs),has allowed the enantioselective synthesis of these spirocyclic compounds despite its inherent *** this work,we describe the fully diastereo-and highly enantioselective synthesis of novel spirocyclic pyrazolone γ-butyrolactones via NHC-catalysed[3+2]annulation reaction of enals and 1H-pyrazol-4,*** understand the catalytic mechanism and origin of stereoselectivity,electronic structure calculations were carried *** considering various pathways,we concluded that the stereoselectivity-determining step is the formation of the lactone that proceeds after addition of the NHC derived homoenolate to the electrophilic carbonyl group of pyrazolin-4,*** calculations predict that the free energy barrier is lower for the(RS)product,which is also the main product experimentally obtained.

关键词： synthesis spiro mechanism

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