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Management of Complex Wounds with Dermal Substitute Assisted by a Negative Pressure System

Modern Plastic Surgery 2023年第4期13卷 95-105页

作者： Cuahutémoc Márquez Espriella Ruiz Garza Jorge Gerardo Barbosa Villarreal Fernando Dávila Díaz Rodrigo Cuervo Vergara Marco Antonio campollo lópez ana priscila Gutierrez Alvarez Mauricio Chama Naranjo Alfredo García Corral Jesús Ricardo Pérez Benítez Omar Alberto Pulido lópez Ricardo Alberto Jaimes Duran Edwing Michel Garibaldi Bernot Mauro Cortes Aguilar Carlos Manuel García Córdova Carlos Emiliano Camacho Rodriguez Hayah Camacho Rodriguez Hayah Martinez Villalobos Claudia Nallely Ochoa Contreras Erick Cesar Randall Cruz Soto Herrera lozano luis Arturo Department of Plastic and Reconstructive Surgery Hospital Central Sur Petróleos Mexicanos Mexico City Mexico

Introduction: The standard treatment for complex wound care is autografting. The advent of dermal substitutes has provided a novel tool for the preparation of the bed to be grafted. However, most types of dermal matrices require the application of a skin graft a second time. Currently, other strategies have been developed to improve the vascularization process, such as negative pressure wound therapy (NPWT), which has been reported to reduce the time required for vascular growth and dermal matrix integration and thus achieve a shorter waiting period for autologous graft application. The present study aims to evaluate the effectiveness and safety of dermal matrix management associated with NPWT in the treatment of complex wounds. Methods: Seven patients with a diagnosis of complex wounds were enrolled in this study between July 1, 2015, and June 31, 2016. After debridement and having an adequate wound bed, patients who met the criteria for the application of combined therapy were treated with dermal substitutes and a negative pressure system. The percentage of graft integration into the wound bed, complications, length of hospital stay, and duration of therapy were analyzed. Results: The mean age was 42.5 ± 16 (39 - 54) years old;three women and four men were included in the study. The approximate size of skin loss was 120.7 ± 75 cm2 (25 - 250 cm2). The combined therapy of dermal matrix plus NPWT was instituted in all cases for a period of 14 days. There were no complications, with 100% graft integration in 6 of 7 cases. Patients were discharged after a mean hospital stay of 5.4 days. Conclusions: This study demonstrates that the utilization of combined dermal matrix plus NPWT therapy can be performed safely and effectively in patients with complex wounds with low complication rates and a short hospital stay.

关键词： Negative Pressure Wound Therapy Complex Wound Dermal Matrix Wound Therapy

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Assessment of periportal fibrosis in Schistosomiasis mansoni patients by proton nuclear magnetic resonance-based metabonomics models

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World Journal of Hepatology 2022年第4期14卷 719-728页

作者： Milena lima Rodrigues Tatiane priscila Santos Rodrigues da luz Caroline louise Diniz Pereira Andrea Dória Batista ana lúcia Coutinho Domingues Ricardo Oliveira Silva Edmundo Pessoa lopes Programa de Pós-Graduação em Medicina Tropical Centro de Ciências MédicasUniversidade Federal de PernambucoRecife 50670-901PernambucoBrazil Programa de Pós-Graduação em Química Centro de Ciências Exatas e da NaturezaUniversidade Federal de PernambucoRecife 50670-740PernambucoBrazil Hospital das Clínicas Departamento de Medicina ClínicaUniversidade Federal de PernambucoRecife 50670-901PernambucoBrazil

BACKGROUND The evaluation of periportal fibrosis(PPF)is essential for a prognostic assessment of patients with Schistosomiasis mansoni.The WHO Niamey Protocol defines patterns of fibrosis from abdominal ultrasonography,^(1)H-nuclear magnetic resonance(NMR)-based metabonomics has been employed to assess liver fibrosis in some diseases.AIM To build 1H-NMR-based metabonomics models(MM)to discriminate mild from significant periportal PPF and identify differences in the metabolite profiles.METHODS A prospective cross-sectional study was performed on schistosomiasis patients at a University Hospital in Northeastern Brazil.We evaluated 41 serum samples from 10 patients with mild PPF(C Niamey pattern)and 31 patients with significant PPF(D/E/F Niamey patterns).MM were built using partial least squares-discriminant analysis(PlS-DA)and orthogonal projections to latent structures discriminant analysis(OPlS-DA)formalisms.RESUlTS PlS-DA and OPlS-DA resulted in discrimination between mild and significant PPF groups with R2 and Q2 values of 0.80 and 0.38 and 0.72 and 0.42 for each model,respectively.The OPlS-DA model presented accuracy,sensitivity,and specificity values of 92.7%,90.3%,and 100%to discriminate significant PPF.The metabolites identified as responsible by discrimination were:Nacetylglucosamines,alanine,glycolaldehyde,carbohydrates,and valine.CONClUSION MMs discriminated mild from significant PPF patterns in patients with Schistosomiasis mansoni through identification of differences in serum metabolites profiles.

关键词： Metabolomics Portal hypertension Schistosoma mansoni Biomarkers Neglected disease Nuclear magnetic resonance

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Diagnostic criteria for autoimmune hepatitis in children: A challenge for pediatric hepatologists

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World Journal of Gastroenterology 2012年第33期18卷 4470-4473页

作者： priscila Menezes Ferri Alexandre Rodrigues Ferreira Débora Marques Miranda ana Cristina Sim■es e Silva Division of Pediatric Gastroenterology and Hepatology Department of Pediatrics School Medicine Federal University of Minas Gerais Minas Gerais 30130-100 Brazil National Institute of Science and Technology of Molecular Medicine Faculty of Medicine Federal University of Minas Gerais Minas Gerais 30130-100 Brazil

Autoimmune hepatitis (AIH) is a progressive inflammatory liver disorder that is rare in children and adolescents. AIH has a broad clinical spectrum and a quick response to treatment with corticosteroids and immunosuppressive medication. The available diagnosis criteria have limitations and should be evaluated in pediatric populations. Recently, some studies reported that the 2008 simplified diagnostic criteria for AIH could be used in children with high sensibility and specificity. In addition, the authors reported that globulin and immunoglobulin G levels can be used interchangeably for diagnostic purposes. They also demonstrated that the 2008 simplified criteria fail in identifying patients with fulminant hepatic failure. Here, we discuss the limitations of the use of these criteria in pediatric patients and the requirement of more studies to improve the diagnosis of AIH in children.

关键词：自身免疫性儿童标准诊断肝病肝炎小儿免疫球蛋白G

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Anthropometric Breast Measurements: analysis of the Average Breast in the Mexican Female Population

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Journal of Biosciences and Medicines 2022年第3期10卷 124-135页

作者： David Flores-Soto Jose C. Martinez-lópez Fernando Barbosa-Villarreal Fernando I. Recio-Espana Jaime A. García-Espinoza Alfredo Chama-Naranjo ana P. campollo-lopez D. Deluna-Gallardo Alejandro Costa-Dulche Cuahutemoc Márquez-Espriella Division of Plastic and Reconstructive Surgery Hospital Central Sur de Alta Especialidad de Petróleos Mexicanos Mexico City Mexico

Introduction: The elements and perception of beauty vary between populations around the world. To obtain better results, surgical techniques should be planned based on anthropometric characteristics of the race, location, and body mass index (BMI). Objectives: To determine which are the standard measurements and anatomical proportions of the breast in a healthy Mexican women population. Materials and Methods: Female Mexican volunteers between 20 and 60 years of age, without any history of breast illness or breast surgery were studied. Demographic information and standard breast anthropometric measurements were collected manually by one of the authors. For the statistical analysis a Student-T test was performed, and the Pearson correlation coefficient was obtained using the latest version of SPSS software. Results: 78 volunteers were included in the analysis. Mean height, weight and BMI were 1.6 m, 68.9 Kg, and 26.6 Kg/m2 respectively. The mean anthropometric values found were: Supra Sternal notch to nipple distance (SSN:N) 22 cm, Breast volume (BV) 372.6 cm3, Upper breast pole length (UBPl) 11 cm, lower Breast Pole length (lBPl) 7.7 cm, Midline to Nipple distance (Ml:N) 10.2 cm, Transverse diameter of the Nipple areola complex (NAC-T) 4.1 cm, Height of the Nipple Areola Complex (NAC-H) 4.1 cm, Base of the breast (BB) 13.4 cm, Upper Pole to lower Pole Ratio (UPP:lPP) 58.9:41.1. A statistically significant difference between Right and left breast was not found. The UPP/ lPP ratio in our population is far different from what is considered internationally aesthetic (45:55). A positive correlation was found between weight/ BMI and SSN:N, BV, BB, Ml:N and lBPl. Also between age and SSN:N, lBPl, BV and BB. Conclusion: This study sets the Anthropometric grounds in Mexican population for an objective individual patient analysis and comparison with the female population of this and other nations.

关键词： Average Breast Anthropometric Measurements Mexico Breast Anthropometric Measurements Mexico

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Epidemiology of Fingertip Injuries at South Central Hospital Petróleos Mexicanos “Pemex” with a Review of the literature

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Journal of Biosciences and Medicines 2023年第6期11卷 182-195页

作者： Fernando Barbosa-Villarreal Cuahutémoc Márquez-Espriella Erika Barlandas-Quintana ana priscila campollo-lópez Mauricio Gutiérrez-Álvarez Carlos Emiliano García-Córdova Jesús Ricardo García-Corral Alfredo Chama-Naranjo Ricardo Alberto Pulido-lópez Patricia llizette lópez-Medellín Edgar Alan Guillen-Martínez Jonathan Steve Rodríguez-Alaníz Edwing Michel Jaimes-Duran Carlos Manuel Cortes-Aguilar Mauro Garibaldi-Bernot Omar Alberto Pérez-Benítez Miguel Eduardo Marín-Canto luis Arturo Herrera-lozano Héctor Manuel Suarez-Ortega Alejandro Cruz-Zarate Department of Plastic and Reconstructive Surgery Hospital Central Sur Petróleos Mexicanos Mexico City Mexico

Background: The hand is an essential component for performing our daily tasks;as a result, injuries to the fingertip are frequently seen. Accurate evaluation and treatment of fingertip injuries are essential to avoiding long-term disability, job loss and psychological issues. No matter the injury classification system, maintaining finger length, regaining sensation, and improving appearance are the three main objectives of treatment. The objective of this research was to outline the epidemiology of fingertip injuries treated between 2021 and 2022 at a highly specialized referral hospital in Mexico City. Methodology: This investigation is cross-sectional, retrospective, and observational. From January 2021 to December 2022, 60 patients with a diagnosis of fingertip injury from the South Central Hospital “Pemex” were included. The descriptive statistical analysis was performed using SPSS29. Results: 60 patients were included, 27 (45%) were women and 33 (55%) were men. Allen’s classification was able to classify only 19 patients, of which 18 (94.7%) had a type 1 classification and one (5.26%) had a type 2 classification. 10% of patients experienced complications, which included 2 patients with surgical site infections (3.3%), 3 patients with persistent pain (5%), and 1 patient (1.6%) with graft rejection. Conclusions: There are currently insufficient epidemiological data on hand and wrist injuries and its effects on labor in Mexico. Fingertip injuries require particular care in order to prevent complications and long-term damage. The creation of national registries could help with the creation of reference manuals for the care of hand and wrist injuries in our nation.

关键词： Fingertip Fingertip Injuries Epidemiology

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Managament Wound Healing: The Importance of a Wound Clinic in Hospital Centers

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现代整形外科(英文) 2023年第4期13卷 118-125页

作者： Alfredo Chama Naranjo Cuahutémoc Márquez Espriella Alberto Ignacio Cahuana Quispe Barbosa Villarreal Fernando ana priscila campollo lópez Mauricio Gutiérrez Álvarez Carlos Emiliano García Córdova Jesús Ricardo García Corral Cuervo Vergara Marco Antonio Jorge luis Rosales Becerra Dávila Díaz Rodrigo Edgar Alan Guillen Martínez Marín Canto Miguel Eduardo luis Arturo Herrera lozano Ochoa Contreras Erick Cesar Martinez Villalobos Claudia Nallely Cruz Soto Randall Camacho Rodriguez Hayah Ricardo Alberto Pulido lópez Edwing Michel Jaimes Durán Department of Plastic and Restrictive Surgery Hospital Central Sur de Alta Especialidad Pemex Mexico City Mexico

Background: In clinical practice, acute and chronic wounds continue to be a challenge. Unfortunately, wound care is often inadequate or inappropriate. The implementation of wound clinics involving an interdisciplinary team for wound care and treatment yields favorable clinical outcomes as well as a reduction in economic expenses due to a higher rate of healing, a decrease in hospital stays, and a reduction in the number of readmissions. The establishment of wound clinics enhances the utilization of diagnostic, preventive, and therapeutic resources, improving the quality of life of patients and facilitating their reintegration into their normal lives. The objective is solely to describe the importance of wound clinics in the medical profession. Methods: A retrospective literature search was conducted to include articles no more than 10 years old that reported measures or results of the study in order to perform a literature review and describe the importance of wound clinics in medical practice. Results: A total of 7 articles were obtained with the inclusion criteria, the most recent being from the year 2023 and the oldest from 2013. Conclusion: An important area for improvement in the healthcare industry is the management and treatment of complex wounds. The establishment of wound clinics offers comprehensive and specialized care for both acute and chronic complex wounds with the goal of enhancing secondary illness patients’ prevention, treatment, and rehabilitation.

关键词： Wound Clinic Pressure Ulcer Chronic Wound Wound Healing Quality of life

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Description of the Factors Associated with Trigger Finger in Patients Treated at Petroleos Mexicanos “Pemex”

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Journal of Biosciences and Medicines 2023年第7期11卷 151-159页

作者： Fernando Barbosa-Villarreal Cuahutémoc Márquez-Espriella Rodrigo Dávila-Díaz Marco A. Cuervo-Vergara Blanca Y. Arambula-Sánchez Alberto I. Cahuana-Quispe Victor A. Esquivel-Chávez Carlos E. García-Córdova ana P. campollo-lópez Mauricio Gutierrez-Alvarez Jesus R. García-Corral Alfredo Chama-Naranjo Daniel de luna-Gallardo Ricardo A. Pulido-lópez Isaac F. Recio-España Esteban I. Campos-Serna Carlos I. Navarro-Delgadillo José C. Martínez-lópez Victor H. Avalos-Gómez Alejandro Cruz-Zarate Department of Plastic and Reconstructive Surgery Hospital Central Sur Petróleos Mexicanos Mexico City Mexico

Background: The trigger finger, also known as stenosing tenosynovitis of the flexor tendon, is a common cause of hand disability;This can result in significant limitations in certain daily living activities. It is possible to treat this condition with conservative or surgical methods. Methods: This is a retrospective, observational, cross-sectional and descriptive study. The source population consisted of all patients with a diagnosis of trigger finger who had been treated in the department of plastic and reconstructive surgery of our institution between 2020 and 2023. The primary objective of this study is to determine the prevalence and characterize the clinical and surgical characteristics of the population affected by trigger finger in our hospital. Results: The total population was 237 patients, of which 165 were women (70%) and 72 men (30%). The most affected hand was the right hand, with a total of 158 patients (67%). In the right hand, the middle finger was the most affected (45%). Of the 237 patients, 80 of them had obesity (34%), 86 had type 2 diabetes mellitus (36%), 95 had systemic arterial hypertension (40%). Open technique was performed in 190 (80%) patients, while percutaneous technique was performed in 47 (20%) of them. Conclusion: The female sex was twice as frequent, and the middle finger and thumb were the most affected. Most of the patients received surgical treatment with open approach and percutaneous approach in 20% of them.

关键词： Trigger Finger Tendinopathy

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Breast Reconstruction: Does It Worth to Start If the Patient Is Not Sure to Take All the Process Along?

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Journal of Biosciences and Medicines 2022年第8期10卷 201-209页

作者： Jesús Ricardo García-Corral José Martínez-lopez Rodrigo Davila-Diaz Blanca Arambula-Sanchez Marco Cuervo-Vergara Fernando Barbosa-Villarreal Daniel De luna ana priscila campollo lopez Fernando Isaac Recio Espana Alfredo Chama Naranjo Jaime García Alejandro Costa David Flores-Soto Selina Marioni-Manriquez Patricia lopez-Medellin Erika Barlandas-Quintana Edgar Guillen-Martinez Steve Rodriguez-Alanis Cuahutemoc Marquez Departamento de Cirugía Plástica y Reconstructiva Hospital Central Sur de Alta Especialidad PEMEX Mexico City Mexico

Introduction: Breast cancer is the most common cancer in women worldwide, representing a major public health problem. There is still little information comparing the satisfaction of the patients who finished their process against the ones who start it but did not finish it. The aim of our retrospective study was to analyze the results in terms of satisfaction after one year of undergoing to complete breast reconstruction (CBR) vs incomplete breast reconstruction (IBR). Materials and Methods: Retrospective study of patients that underwent breast reconstruction (BR) surgery after mastectomy for breast cancer treatment. Performed at Hospital Central Sur de Alta Especialidad PEMEX in Mexico City, including patients from January 1, 2015 to January 01, 2020. Demographic baseline variables were included. BREAST-Q satisfaction questionnaires one year after the last reconstructive procedure were analyzed. Results: A total of 44 patients fulfilled the inclusion criteria. Of these 44 patients, 11 were included in the IBR group, and 33 patients in the CBR group. There were no statistically significant differences between the two groups in terms of age (IBR 56.09 vs CBR 53.06 years, p = 0.321);BMI (IBR 27.94 vs CBR 26.40, p = 0.253), time from mastectomy to first reconstructive procedure (IBR 22.8 vs CBR 31 months, p = 0.957), history of chemotherapy (IBR 27.3% vs CBR 33.3%, p = 0.709) and radiotherapy (IBR 54.5% vs CBR 42.4%, p = 0.484), additionally type of reconstruction, affected side or complication rate were not significantly different. Regarding postoperative satisfaction, only the second module of satisfaction with breasts displayed statistically significant differences, with a higher score in the CBR group (46.27 vs 52.27, p = 0.019). Other items explored didn’t show significant differences. Discussion: The data reported in this study suggest that regardless of whether the last stage of a BR is reached, the results in these settings can be very similar in terms of psychosocial well-being, sexual well-being, physical

关键词： BREAST-Q Breast Reconstruction Satisfaction Index Quality of life Breast Cancer Patient’s Decision Making

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NT157 has antineoplastic effects and inhibits IRS1/2 and STAT3/5 in JAK2^(V617F)-positive myeloproliferative neoplasm cells

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Signal Transduction and Targeted Therapy 2020年第1期5卷 2440-2449页

作者： Bruna Alves Fenerich Jaqueline Cristina Fernandes ana Paula Nunes Rodrigues Alves Juan luiz Coelho-Silva Renata Scopim-Ribeiro priscila Santos Scheucher Christopher A.Eide Cristina E.Tognon Brian J.Druker Eduardo Magalhães Rego João Agostinho Machado-Neto Fabiola Traina Department of Medical Images Hematologyand Clinical OncologyUniversity of Sao Paulo at Ribeirao Preto Medical SchoolRibeirao PretoSao PauloBrazil Center for Cell-Based Therapy Sao Paulo Research FoundationRibeirao PretoSao PauloBrazil Knight Cancer Institute Oregon Health&Science UniversityPortlandORUSA Howard Hughes Medical Institute PortlandORUSA Department of Internal Medicine University of Sao Paulo Medical SchoolSao PauloBrazil Department of Pharmacology Institute of Biomedical Sciences of the University of Sao PauloSao PauloBrazil

Recent data indicate that IGF1R/IRS signaling is a potential therapeutic target in BCR-ABl1-negative myeloproliferative neoplasms(MPN);in this pathway,IRS2 is involved in the malignant transformation induced by JAK2^(V617F),and upregulation of IGF1R signaling induces the MPN phenotype.NT157,a synthetic compound designed as an IGF1R-IRS1/2 inhibitor,has been shown to induce antineoplastic effects in solid tumors.Herein,we aimed to characterize the molecular and cellular effects of NT157 in JAK2^(V617F)positive MPN cell lines(HEl and SET2)and primary patient hematopoietic cells.In JAK2^(V617F)cell lines,NT157 decreased cell viability,clonogenicity,and cell proliferation,resulting in increases in apoptosis and cell cycle arrest in the G2/M phase(pling,and it activated the AP-1 complex,downregulated four oncogenes(CCND1,MYB,WT1,and NFKB1),and upregulated three apoptotic-related genes(CDKN1A,FOS,and JUN)(plony formation in cells from polycythemia vera patients(plucidate the mechanism of NT157 action in a MPN context and suggest that targeting IRS1/2 proteins may represent a promising therapeutic strategy for MPN.

关键词： JAK2 IGF1R neoplasms STAT3

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Autoimmune hepatitis in childhood: The role of genetic and immune factors

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World Journal of Gastroenterology 2013年第28期19卷 4455-4463页

作者： priscila Menezes Ferri liu Débora Marques de Miranda Eleonora Druve Tavares Fagundes Alexandre Rodrigues Ferreira ana Cristina Simoes e Silva Department of Pediatrics Interdisciplinary Laboratory of Medical Investigation Federal University of Minas Gerais Belo Horizonte Minas Gerais 30130-100 Brazil National Institute of Science and Technology of Molecular Medicine (INCT-MM) CNPq-FAPEMIG Federal University of Minas Gerais Belo Horizonte Minas Gerais 30130-100 Brazil

Autoimmune hepatitis (AIH) is a rare chronic inflammatory disease of the liver, which affects a group of patients who lost their immunological tolerance to antigens of the liver. It is clinically characterized by hypergammaglobulinemia, elevated liver enzymes, presence of autoantibodies and histological changes. Although being rare in children, it represents a serious cause of chronic hepatic disease that can lead to cirrhosis and hepatic failure. Clinical findings, exclusion of more common liver disorders and the detection of antibodies antinuclear antibodies, smooth muscle antibodies and anti-lKM1 are usually enough for diagnosis on clinical practice. The pathogenic mechanisms that lead to AIH remain obscure, but some research findings suggest the participation of immunologic and genetic factors. It is not yet knew the triggering factor or factors that stimulate inflammatory response. Several mechanisms proposed partially explain the immunologic findings of AIH. The knowledge of immune factors evolved might result in better markers of prognosis and response to treatment. In this review, we aim to evaluate the findings of research about genetic and immune markers and their perspectives of application in clinical practice especially in pediatric population.

关键词： Autoimmune hepatitis Genetics Clinical practice Immunophenotype

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