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From liver to hormones:The endocrine consequences of cirrhosis

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World Journal of Gastroenterology 2024年第9期30卷 1073-1095页

作者： Juan Eduardo Quiroz-Aldave Elman Rolando Gamarra-Osorio María del Carmen Durand-Vásquez luciana del Pilar Rafael-Robles Jhean Gabriel Gonzáles-Yovera María Alejandra Quispe-Flores luis Alberto Concepción-Urteaga Alejandro román-González José Paz-Ibarra Marcio José Concepción-Zavaleta non-communicable Diseases Endocrinology Research LineHospital de Apoyo ChepénChepén 13871Peru Department of Endocrinology Hospital Víctor Lazarte EchegarayTrujillo 13006Peru Department of Endocrinology Clínica Javier PradoLima 15046Peru Department of Gastroenterology Hospital Nacional Guillermo Almenara IrigoyénLima 15018Peru Department of Endocrinology Hospital de Emergencias GrauLima 15001Peru Internal Medicine Hospital Regional Docente de TrujilloTrujillo 13011Peru Department of Endocrinology Hospital Universitario de San Vicente FundaciónMedellin 050010Colombia Internal Medicine Universidad de AntioquiaMedellín 050010Colombia School of Medicine Universidad Nacional Mayor de San MarcosLima 15081Peru Department of Endocrinology Hospital Nacional Edgardo Rebagliati MartinsLima 15072Peru Carrera de Medicina Humana Universidad Científica del SurLima 15067Peru

Hepatocrinology explores the intricate relationship between liver function and the endocrine *** liver diseases such as liver cirrhosis can cause endocrine disorders due to toxin accumulation and protein synthesis *** its importance,assessing endocrine issues in cirrhotic patients is frequently *** article provides a comprehensive review of the epidemiology,pathophysiology,diagnosis,and treatment of endocrine disturbances in liver *** review was conducted using the PubMed/Medline,EMBASE,and Scielo databases,encompassing 172 *** cirrhosis is associated with endocrine disturbances,including diabetes,hypoglycemia,sarcopenia,thyroid dysfunction,hypogonadotropic hypogonadism,bone disease,adrenal insufficiency,growth hormone dysfunction,and secondary *** optimal tools for diagnosing diabetes and detecting hypoglycemia are the oral glucose tolerance test and continuous glucose monitoring system,*** can be assessed through imaging and functional tests,while other endocrine disorders are evaluated using hormonal assays and imaging *** options include metformin,glucagon-like peptide-1 analogs,sodium-glucose co-transporter-2 inhibitors,and insulin,which are effective and safe for diabetes *** standards are followed for managing hypoglycemia,and hormone replacement therapy is often necessary for other endocrine *** transplantation can address some of these problems.

关键词： Diabetes mellitus Hypoglycemia Thyroid diseases Hypogonadism Metabolic bone diseases liver cirrhosis

Game changer:How Janus kinase inhibitors are reshaping the landscape of ulcerative colitis mana

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World Journal of Gastroenterology 2024年第35期30卷 3942-3953页

作者： antonio M Caballero-Mateos Guillermo Arturo Cañadas-de la Fuente Department of Gastroenterology and Hepatology San Cecilio University HospitalGranada 18014Spain Department of nursing Faculty of Health SciencesUniversity of GranadaGranada 18004Spain

Recent advancements in the treatment landscape of ulcerative colitis(UC)have ushered in a new era of possibilities,particularly with the introduction of Janus kinase(JAK)-signal transducer and activator of transcription *** novel agents offer a paradigm shift in UC management by targeting key signaling pathways involved in inflammatory *** approved JAK inhibitors(JAKis),such as tofacitinib,filgotinib,and upadacitinib,clinicians now have powerful tools to modulate immune responses and gene expression,potentially revolutionizing the treatment algorithm for *** trials have demonstrated the efficacy of JAKis in inducing and maintaining remission,presenting viable options for patients who have failed conventional ***-world data support the use of JAKis not only as first-line treatments but also in subsequent lines of therapy,particularly in patients with aggressive disease phenotypes or refractory to biologic *** rapid onset of action and potency of JAKis have broadened the possibilities in the management strategies of UC,offering timely relief for patients with active disease and facilitating personalized treatment *** safety concerns,including cardiovascular risks and infections,ongoing research and post-marketing surveillance will continue to refine our understanding of the risk-benefit profile of JAKis in UC management.

关键词： Ulcerative colitis Janus kinase inhibitors Filgotinib Tofacitinib Upadacitinib

Breaking paradigms: long non-coding RnAs forming gene fusions with potential implications in cancer

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Genes & Diseases 2024年第3期11卷 311-323页

作者： David sanchez-Marin Macrina Beatriz Silva-Cazares Fany Iris Porras-Reyes Rebeca Garcia-roman Alma D.Campos-Parra Posgrado en Ciencias Biologicas Facultad de MedicinaUniversidad Nacional Autonoma de MexicoCiudad de MexicoC.P.04360Mexico Unidad Academica Multidisciplinaria Region Altiplano Universidad Autonoma de San Luis Potost(UASLP)Carretera a Cedral Km 5+600Ejido San Jose de la TrojesMatehualaSan Luis PotosiC.P.78760Mexico Servicio de Anatomia Patologica Instituto Nacional de Cancerologia(INCan)Nino JesuisTlalpanCiudaddeMexicoC.P.14080Mexico Instituto de Salud Publica Universidad Veracruzana(UV)Av.Dr LuisDr.Castelazo Ayala s/nCol.Industrial AnimasXalapaVeracruzC.P.91190Mexico

long non-coding RnAs(lncRnAs)are non-coding RnAs longer than 200 nucleotides with dynamic regulatory *** interact with a wide range of molecules such as DnA,RnA,and proteins to modulate diverse cellular functions through several mechanisms and,if deregulated,they can lead to cancer development and ***,it has been described that IncRnAs are susceptible to form gene fusions with mRnAs or other IncRnAs,breaking the paradigm of gene fusions consisting mainly of protein-coding ***,their biological significance in the tumor phenotype is still ***,their recent identification opens a new line of research to study their biological role in tumor-igenesis,and their potential as biomarkers with clinical relevance or as therapeutic *** present study aimed to review the IncRnA fusions identified so far and to know which of them have been associated with a potential *** address the current challenges to deepen their study as well as the reasons why they represent a future therapeutic window incancer.

关键词： Cancer Genefusions IncRnAs ncRnAs Therapy

Management of cerebral amyloid angiopathy and atrial fibrillation:We are still far from precision medicine

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World Journal of Cardiology 2024年第5期16卷 231-239页

作者： liuba Fusco Zefferino Palamà antonio Scarà Alessio Borrelli antonio Gianluca Robles Gabriele De Masi Deluca Silvio romano luigi Sciarra Department of Cardiology University Hospital of NorthamptonshireNorthampton NN15BDUnited Kingdom Department of Cardiology Casa di Cura Villa VerdeTaranto 70124Italy Department of life Health and Environmental SciencesUniversity of l'AquilaL'Aquila 67100Italy Department of Cardiology GVM Care and ResearchSan Carlo di Nancy HospitalRome 00100Italy

The use of anticoagulation therapy could prove to be controversial when trying to balance ischemic stroke and intracranial bleeding risks in patients with concurrent cerebral amyloid angiopathy(CAA)and atrial fibrillation(AF).In fact,CAA is an age-related cerebral vasculopathy that predisposes patients to intracerebral ***,many AF patients require oral systemic dose-adjusted warfarin,direct oral anticoagulants(such as factor Xa inhibitors)or direct thrombin inhibitors to control often associated with cardioembolic stroke *** prevalence of both CAA and AF is expected to rise,due to the aging of the *** clinical dilemma is becoming increasingly *** patients with coexisting AF and CAA,the risks/benefits profile of anticoagulant therapy must be assessed for each patient individually due to the lack of a clear-cut consensus with regard to its risks in scientific *** review aims to provide an overview of the management of patients with concomitant AF and CAA and proposes the implementation of a risk-based decision-making algorithm.

关键词： Anticoagulation Atrial fibrillation Cerebral amyloid angiopathy Intracerebral hemorrhage Stroke Watchman Secondary prevention left atrial appendage closure

non-anatomical liver resection for hepatocellular carcinoma:the SegSubTe classification to overcome the problem of heterogeneity

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Hepatobiliary & Pancreatic Diseases International 2024年第3期23卷 265-271页

作者： Mattia Garancini Alessandro Fogliati Mauro Alessandro Scotti Cristina Ciulli Francesca Carissimi antonio Rovere luca Gianotti Fabrizio romano Unit of Hepatobiliopancreatic Surgery Department of SurgeryASST-MonzaSan Gerardo HospitalUniversity of Milano-Bicoccavia Pergolesi 33MonzaMB 20052Italy Interventional Radiology Department of RadiologyASST-MonzaSan Gerardo HospitalMilano-Bicocca Universityvia Pergolesi 33MonzaMB 20052Italy

Background:The superiority of anatomical resection(AR)***-anatomical resection(nAR)in the surgical management of hepatocellular carcinoma(HCC)is *** are well-defined procedures,whereas the lack of nAR standardization results in heterogeneous *** study aimed to introduce the SegSubTe classification for nAR detailing the appropriateness of the level of surgical section of the Glissonean pedicles feeding the ***:A single-center retrospective analysis of pre-and postoperative imaging of consecutive patients treated with nAR for single HCC between 2012 and 2020 was *** quality of surgery was assessed classifying the type of vascular supply and the level of surgical section(segmental,subsegmental or terminal next to the tumor)of vascular pedicles feeding the HCCs;then,the population was divided in“SegSubTe-In”or“SegSubTe-OUT”groups,and the tumor recurrence and survival were ***:ninety-seven patients who underwent nAR were included;76%were SegSubTe-In and 24%were *** disease recurrence,local recurrence and cut-edge recurrence in the SegSubTe-In ***-OUT groups were 50%vs.83%(P=0.006),20%vs.52%(P=0.003)and 16%vs.39%(P=0.020),***-OUT odds ratio for local recurrence was 4.1 at univariate regression ***-,three-,and five-year disease-free survival rates in the SegSubTe-In ***-OUT groups were 81%,58%and 35%vs.46%,21%and 11%,respectively(Pnclusions:The SegSubTe classification is a useful tool to stratify and standardize nAR for HCC,aiming at improving long-term oncological outcomes and reducing the heterogeneity of quality of nAR for HCC.

关键词： Hepatocellular carcinoma Intraoperative ultrasound liver surgery Computed tomography Surgical procedure

Clinical significance of donor-specific human leukocyte antigen antibodies in liver transplantation

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World Journal of Gastroenterology 2015年第39期21卷 11016-11026页

作者： antonio Cuadrado David san Segundo Marcos lópez-Hoyos Javier Crespo Emilio Fábrega Gastro- enterology and Hepatology Unit Marqués de Valdecilla University Hospital Instituto de Investigación Marqués de Valdecilla Immunology Unit Marqués de Valdecilla University Hospital. Instituto de Investigación Marqués de Valdecilla

Antibody-mediated rejection(AMR) caused by donorspecific anti-human leukocyte antigen antibodies(DSA) is widely accepted to be a risk factor for decreased graft survival after kidney transplantation. This entity also plays a pathogenic role in other solid organ transplants as it appears to be an increasingly common cause of heart graft dysfunction and an emerging issue in lung transplantation. In contrast, the liver appears relatively resistant to DSA-mediated injury. This "immune-tolerance" liver property has been sustained by a low rate of liver graft loss in patients with preformed DSA and by the intrinsic liver characteristics that favor the absorption and elimination of DSA; however, alloantibody-mediated adverse consequences are increasingly being recognized, and several cases of acute AMR after ABO-compatible liver transplant(lT) have been reported. Furthermore, the availability of new solid-phase assays, allowing the detection of low titers of DSA and the refinement of objective diagnostic criteria for AMR in solid organ transplants and particularly in lT, have improved the recognition and management of this entity. A cost-effective strategy of DSA monitoring, avoidance of class Ⅱ human leukocyte antigen mismatching, judicious immunosuppression attached to a higher level of clinical suspicion of AMR, particularly in cases unresponsive to conventional antirejection therapy, can allow a rational approach to this threat.

关键词： Donor-specific anti-human leukocyte antigen antibo

Therapeutic targeting of cellular prion protein: toward the development of dual mechanism anti-prion compounds

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neural Regeneration Research 2025年第4期20卷 1009-1014页

作者： antonio Masone Chiara Zucchelli Enrico Caruso Giovanna Musco Roberto Chiesa laboratory of Prion neurobiology Department of NeuroscienceIstituto di Ricerche Farmacologiche Mario Negri IRCCSMilanItaly Biomolecular nMR Unit Division of Genetics and Cell BiologyIRCCS Ospedale San RaffaeleMilanItaly Department of Biotechnology and life Sciences University of InsubriaVareseItaly

PrPSc,a misfolded,aggregation-prone isoform of the cellular prion protein(PrPC),is the infectious prion agent responsible for fatal neurodegenerative diseases of humans and other *** adopt different pathogenic conformations(prion strains),which can be resistant to potential drugs,or acquire drug resistance,posing challenges for the development of effective *** PrPCis the obligate precursor of any prion strain and serves as the mediator of prion neurotoxicity,it represents an attractive therapeutic target fo r prion *** this minireview,we briefly outline the approaches to target PrPCand discuss our recent identification of Zn(Ⅱ)-Bn PyP,a PrPC-targeting porphyrin with an unprecedented bimodal mechanism of *** argue that in-depth understanding of the molecular mechanism by which Zn(Ⅱ)-Bn PyP targets PrPCmay lead toward the development of a new class of dual mechanism anti-prion compounds.

关键词： anti-prion drug anti-PrPC antibody antisense oligonucleotide neurodegeneration pharmacological chaperone porphyrin prion disease PrPC degrader PrPC shedding zinc finger repressor

Risk Factors Associated with Unsuccessful Vaginal Birth after One Cesarean (VBAC-1) in Puerto Rico

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Open Journal of Obstetrics and Gynecology 2024年第6期14卷 888-902页

作者： Irazú Guinan Marjorie Suárez Fabiola Angulo luis Mayol Paula Suárez lisandris Dominicci nathalie Chang Saribel Torres antonio Rodríguez Raymond l. Tremblay Maricarmen Colón-Díaz Department of Physiology and Pathology San Juan Bautista School of Medicine Caguas USA

Background: Cesarean section (CS) has increased steadily over the last decade, with an estimated one-third of women delivering by cesarean section worldwide. Objective: Our study aimed to investigate the demographic and associated factors influencing vaginal birth after one cesarean (VBAC-1) success focusing on variables like pre-pregnancy BMI, diabetes, hypertension, education, and smoking. Study Design and Methods: In this retrospective study, we analyzed 285 cases (81 unsuccessful VBAC-1, 204 successful VBAC-1) from san Juan City Hospital (Puerto Rico) between January 1, 2019, and December 31, 2020. We used odds ratios and model selection comparison to assess the impact of variables on successful VBAC-1, using a significance threshold of 95% CI. Model selection assessed binomial model combinations using a generalized linear approach to identify key risk factors. Results: Unsuccessful VBAC-1 (a repeat cesarean), was associated with diabetes (OR: 0.376, p = 0.086), hypertension (OR: 0.23, p = 0.006), and university-educated women (OR: 1.372, p = 0.711). High school-educated women had an OR of 3.966 (p = 0.105), while overweight women were 0.481 times more likely to have unsuccessful VBAC-1 (p = 0.041). Significant associations were not found with obesity (OR: 0.574, p = 0.122), underweight/normal (OR: 1.01, p = 0.810), or smoking (OR: 1.227, p = 0.990). Conclusion: Results revealed women with higher education levels, hypertension, or diabetes are less likely to have a successful VBAC-1. Understanding the complex interactions affecting these outcomes is aimed at establishing guidelines for healthcare professionals to conduct systematic risk/benefit assessments. This study lays a foundation for evidence-based practices and policies, offering initial insights into VBAC-1 success factors in Puerto Rico.

关键词： Diabetes Hypertension Obesity Trial of labor Vaginal Birth after Cesarean

Corneal collagen cross‑linking epithelium‑on ***‑off:a systematic review and meta‑analysis

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Eye and Vision 2021年第6期8卷 338-352页

作者： Francesco D’Oria antonio Palazón Jorge l.Alio Vissum Innovation c/Cabañal103016 AlicanteSpain Division of Ophthalmology Universidad Miguel HernándezAlicanteSpain Section of Ophthalmology Department of Basic Medical ScienceNeuroscience and Sense OrgansUniversity of BariBariItaly Department of Clinical Medicine Miguel Hernández UniversitySan Juan de AlicanteSpain

Background:The purpose of the study was to determine the advantages and disadvantages of epi-on corneal crosslinking(CXl)techniques compared with standard epi-off ***:We searched MEDlInE and EMBASE for randomized controlled trials(RCTs)and non-randomized studies of interventions(nRSIs)and we evaluated the selected papers according to the Cochrane risk of bias *** considered,as primary outcomes,average Kmax flattening,changes in uncorrected and corrected distance visual acuity(UDVA and CDVA);as secondary outcomes,we considered changes in pachymetry values and endothelial cell density(ECD).We also investigated adverse events related to the treatments and treatment ***-analysis was conducted with a fixed or random-effects model using weighted mean difference(MD)with 95%confidence interval(CI)as the effect ***:A total of 15 studies were included and among these 15 trials,9 were RCTs and 6 were nRSIs,but only 4 studies showed no high risk of bias and were included in this *** analysis revealed significant postoperative differences in CDVA(MD=0.07;95%CI 0.04 to 0.10;Pnd no significative differences in UDVA,Kmax,central corneal thickness(CCT)and ECD(P>0.05).Epi-on CXl protocol was found to be significantly less prompt to have risks of delay in epithelial healing(P=0.035)and persistent stromal haze(P=0.026).Conclusion:Epi-on CXl is as effective as epi-off *** for a higher significant improvement in CDVA with current epi-on protocols,our meta-analysis demonstrates that epi-on and epi-off CXl have comparable effects on visual,topographic,pachymetric,and endothelial ***-on CXl has clinical advantages in terms of comfort and avoidance of complications as it reduces the risk of developing delay in epithelial healing and persistent stromal haze.

关键词： Corneal collagen cross-linking Keratoconus Transepithelial CXl Epithelium-off CXl Epithelium-on CXl Iontophoresis

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