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Gastroenterology training in Latin America

World Journal of Gastroenterology 2011年第18期17卷 2283-2287页

作者： Henry Cohen Roque Saenz Luiz E de Almeida Troncon Maribel Lizarzabal carolina olano Gastroenterology Clinic Montevideo Medical School University del Desarrollo University of So Paulo Ribeiro Preto. Rua Bernardino Campos Rua Bernardino Campos 1000 Ribeirao Preto SP 14015-130 Brazil University del Zulia

Latin America is characterized by ethnic, geographical, cultural, and economic diversity; therefore, training in gastroenterology in the region must be considered in this context. The continent’s medical education is characterized by a lack of standards and the volume of research continues to be relatively small. There is a multiplicity of events in general gastroenterology and in sub-disciplines, both at regional and local levels, which ensure that many colleagues have access to information. Medical education programs must be based on a clinical vision and be considered in close contact with the patients. The programs should be properly supervised, appropriately defined, and evaluated on a regular basis. The disparity between the patients’ needs, the scarce resources available, and the pressures exerted by the health systems on doctors are frequent cited by those complaining of poor professionalism. Teaching development can play a critical role in ensuring the quality of teaching and learning in universities. Continuing professional development programs activities must be planned on the basis of the doctors’ needs, with clearly defined objectives and using proper learning methodologies designed for adults. They must be evaluated and accredited by a competent body, so that they may become the basis of a professional regulatory system. The specialty has made progress in the last decades, offering doctors various possibilities for professional development. The world gastroenterology organization has contributed to the speciality through three distinctive, but closely inter-related, programs: Training Centers, Train-the-Trainers, and Global Guidelines, in which Latin America is deeply involved.

关键词：培训中心胃肠病学拉丁美洲医学教育教学发展学习质量专业发展非洲大陆

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Risk perception and knowledge of COVID-19 in patients with celiac disease

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World Journal of Gastroenterology 2021年第12期27卷 1213-1225页

作者： Jamie Zhen Juan Pablo Stefanolo María de la Paz Temprano Caroline L Seiler Alberto Caminero Enrique de-Madaria Miguel Montoro Huguet Vivas Santiago Sonia Isabel Niveloni Edgardo Gustavo Smecuol Luis Uzcanga Dominguez Elena Trucco Virginia Lopez carolina olano Pasquale Mansueto Antonio Carroccio Peter H Green Donald Duerksen Andrew S Day Jason A Tye-Din Julio César Bai carolina Ciacci Elena F Verdú Benjamin Lebwohl M Ines Pinto-Sanchez Department of Medicine Farncombe Family Digestive Health Research InstituteMcMaster University Medical CenterHamilton Health SciencesHamilton L8S4K1ONCanada Department of Medicine Dr.C.Bonorino Udaondo Gastroenterology HospitalBuenos Aires 1264Argentina Department of Pancreatic Unit Hospital General Universitario de AlicanteAlicante 03010Spain Department of Medicine Instituto Aragonés de Ciencias de la Salud(IACS)Zaragoza 50009Spain Department of Medicine Hospital Universitario San Jorge.HuescaZaragoza 50004Spain Department of Gastroenterology Univ Hosp LeonGastroenterol UnitAltos de Nava S-NLeon 24071Spain Department of Medicine Instituto Nacional de Ciencias Médicas y Nutrición Salvador ZubiránMexico DF 14080Mexico Department of Medicine Universidad de la RepublicMontevideo 11800Uruguay Department of Internal Medicine PROMISE DepartmentUniversity of PalermoPalermo 90127Italy Department of Internal Medicine V.Cervello HospitalPROMISE DepartmentUniversity of PalermoPalermo 90127Italy Celiac Disease Center Columbia University Medical CenterColumbia UnivCeliac Dis CtrDiv Digest and Liver DisNew YorkNY 10032United States Department of Medicine St Boniface Gen HospUniversity of ManitobaWinnipeg R2H 2A6Canada Department of Paediatrics University of Otago ChristchurchChristchurch 8041New Zealand Department of Gastroenterology Royal Melbourne HospitalImmunology DivisionWalter and Eliza Hall InstituteMelbourne 3052Australia Department of Medicine Surgery and DentryScuola Medica SalernitanaUniversity of SalernoCeliac Center at the University Hospital San Giovanni di Dio e Ruggi di AragonaSalerno 84131Italy Department of Medicine Farncombe Family Digestive Research InstituteMcMaster UniversityHamilton L8S4K1ONCanada The Celiac Disease Center Columbia UniversityNew YorkNY 10032United States

BACKGROUND We recently demonstrated that the odds of contracting coronavirus disease 2019(COVID-19)in patients with celiac disease(CeD)is similar to that of the general population.However,how patients with CeD perceive their COVID-19 risk may differ from their actual risk.AIM To investigate risk perceptions of contracting COVID-19 in patients with CeD and determine the factors that may influence their perception.METHODS We distributed a survey throughout 10 countries between March and June 2020 and collected data on demographics,diet,COVID-19 testing,and risk perceptions of COVID-19 in patients with CeD.Participants were recruited through various celiac associations,clinic visits,and social media.Risk perception was assessed by asking individuals whether they believe patients with CeD are at an increased risk of contracting COVID-19 when compared to the general population.Logistic regression was used to determine the influencing factors associated with COVID-19 risk perception,such as age,sex,adherence to a gluten-free diet(GFD),and comorbidities such as cardiac conditions,respiratory conditions,and diabetes.Data was presented as adjusted odds ratios(aORs)RESULTS A total of 10737 participants with CeD completed the survey.From them,6019(56.1%)patients with CeD perceived they were at a higher risk or were unsure if they were at a higher risk of contracting COVID-19 compared to the non-CeD population.A greater proportion of patients with CeD perceived an increased risk of contracting COVID-19 when compared to infections in general due to their CeD(56.1%vs 26.7%,P<0.0001).Consequently,34.8%reported taking extra COVID-19 precautions as a result of their CeD.Members of celiac associations were less likely to perceive an increased risk of COVID-19 when compared to non-members(49.5%vs 57.4%,P<0.0001).Older age(aOR:0.99;95%CI:0.99 to 0.99,P<0.001),male sex(aOR:0.84;95%CI:0.76 to 0.93,P=0.001),and strict adherence to a GFD(aOR:0.89;95%CI:0.82 to 0.96,P=0.007)were associated with a lower perception of COVID-19 risk and the

关键词： Celiac disease Gluten Risk Infection Knowledge Perception Coronavirus COVID-19

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Gastric endoscopic submucosal dissection:From animal model to patient

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World Journal of Gastroenterology 2013年第45期19卷 8326-8334页

作者： Nicolás González Adolfo Parra-Blanco Miguel Villa-Gómez Alejandra Gamba Andrés Taullard Anaulina Silveira Alberto Sanguinetti carolina olano Henry Cohen Department of Gastroenterology Faculty of MedicineHospital de Clínicas Montevideo 11600 Uruguay Department of Gastroenterology Escuela de Medicina Pontificia Universidad Católica de Chile Santiago 6510260 Chile Department of Quantitative Methods Hospital de Clínicas Montevideo 11600 Uruguay

AIM:To assess whether the use of porcine models is useful for learning endoscopic submucosal dissection(ESD),thus contributing to its subsequent application in human patients.METHODS:This study/learning process was carried out in 3 phases:PhaseⅠ:Ex vivo animal;PhaseⅡ:In vivo animal;PhaseⅢ:Humans.One endoscopist performed 30 gastric ESDs in porcine models,and later 5gastric ESDs in 5 patients.The ESD was done following the method practiced at the National Cancer Center in Tokyo,Japan.Technical aspects,size,time and speed of ESD,as well as complications were registered.In patients,their clinical,endoscopic and histologic evolution was additionally added.RESULTS:Thirty en bloc ESDs were carried out in animal models.The mean±SD size of the pieces was of28.4±1.2 mm,and the time of ESD was 41.7±2.4min.The time of ESD in the first 15 procedures was 43.0±3.0 min whereas in the next 15 procedures,the time was 40.3±3.9 min,P=0.588.The speed in the first 15ESDs was 1.25±0.11 cm2/min vs 2.12±0.36 cm2/min in the remaining 15,P=0.028.There were no complications.In patients,5 lesions were resected en bloc.The size of the pieces was 25.2±5.1 mm and the time was85.0±25.6 min.Endoscopic and histological controls did not show evidence of residual neoplastic tissue.CONCLUSION:A sequential ESD training program of a unique endoscopist,based on the practice in porcine models,contributed to learning ESD for its subsequent application in humans,yielding good results in efficacy and safety.

关键词： Endoscopic submucosal dissection Porcine models Animal models Training

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Stereotactic body radiotherapy in pancreatic adenocarcinoma

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Hepatobiliary & Pancreatic Diseases International 2024年第1期23卷 14-19页

作者： carolina de la Pinta Radiation Oncology Department Ramón y Cajal University HospitalIRYCISAlcaláUniversity28034 MadridSpain

Background:Stereotactic body radiotherapy(SBRT)in pancreatic cancer allows high delivery of radiation doses on tumors without affecting surrounding tissue.This review aimed at the SBRT application in the treatment of pancreatic cancer.Data sources:We retrieved articles published in MEDLINE/PubMed from January 2017 to December 2022.Keywords used in the search included:“pancreatic adenocarcinoma”OR“pancreatic cancer”AND“stereotactic ablative radiotherapy(SABR)”OR“stereotactic body radiotherapy(SBRT)”OR“chemoradiotherapy(CRT)”.English language articles with information on technical characteristics,doses and fractionation,indications,recurrence patterns,local control and toxicities of SBRT in pancreatic tumors were included.All articles were assessed for validity and relevant content.Results:Optimal doses and fractionation have not yet been defined.However,SBRT could be the standard treatment in patients with pancreatic adenocarcinoma in addition to CRT.Furthermore,the combination of SBRT with chemotherapy may have additive or synergic effect on pancreatic adenocarcinoma.Conclusions:SBRT is an effective modality for patients with pancreatic cancer,supported by clinical practice guidelines as it has demonstrated good tolerance and good disease control.SBRT opens a possibility of improving outcomes for these patients,both in neoadjuvant treatment and with radical intent.

关键词： Chemoradiotherapy Pancreatic adenocarcinoma Radiotherapy Stereotactic body radiotherapy Stereotactic ablative radiotherapy

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Optimizing oncolytic virus design:a“Swiss army knife”approach to create a systemically delivered therapeutic

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Signal Transduction and Targeted Therapy 2024年第5期9卷 1791-1792页

作者： carolina S.Ilkow John Cameron Bell Ottawa Hospital Research Institute 501 Smyth RoadOttawaONK1H 8L6Canada

In a recent paper published in Nature Biotechnology,Chen et al.1 describe a multiplex oncolytic virus platform that coupled with adoptive T cell therapy could solve the problem of repeat,systemic delivery of virus based therapeutics.It is widely accepted that multi-targeted therapeutic approaches attacking several facets of cancer biology are necessary to effectively deal with the tumor heterogeneity that exists within and between patients.

关键词： therapeutic al. targeted

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Gustatory responsiveness in Vespula germanica workers:exploring the interplay between sensory perception and task specialization

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Insect Science 2024年第2期31卷 587-598页

作者： Analia Mattiacci carolina Mengoni Gonalons MaitéMasciocchi Juan C.Corley Grupo de Ecologia de Poblaciones de Insectos IFAB(CONICETINTA EEA Bariloche)BarilocheArgentina Departamento de Ecologia Centro Regional Universitario BarilocheUniversidad Nacional Del ComahueBarilocheArgentina Departamento de Biodiversidad y Biologia Experimental Facultad de Ciencias Exactas y NaturalesUniversidad de Buenos AiresBuenos AiresArgentina

Workers'task specialization and division of labor are critical features of social insects'ecological success.It has been proposed that the division of labor relies on response threshold models:individuals varying their sensitivity(and responsiveness)to biologically relevant stimuli and performing a specific task when a stimulus exceeds an internal threshold.In this work,we study carbohydrate and protein responsiveness and their relation to worker task specialization in Vespula germanica,an invasive social wasp.The sucrose and peptone responsiveness of two different subcastes,preforagers and foragers,was determined by stimulating the antenna of the wasps with increasing concentrations of the solution and quantifying whether each concentration elicited a licking response.We studied responsiveness in five different ways:(1)response threshold,(2)concentration 50(concentration to which at least 50%of wasps responded),(3)maximum response,(4)mean scores and(5)median scores.Our results suggest that V germanica foragers are more sensitive to sucrose(lower thresholds)than preforager workers.However,we found no differences for peptone thresholds(i.e.,a protein resource).Nonetheless,this is the first study to investigate response thresholds for protein resources.The intercaste variation in sucrose responsiveness shown in our work contributes to the existing knowledge about response threshold theory as a mechanism for task specialization observed in V germanica.

关键词： carbohydrates responsiveness division of labor protein responsiveness response thresholds models social insect yellow jacket

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Ornithine aspartate effects on bacterial composition and metabolic pathways in a rat model of steatotic liver disease

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World Journal of Hepatology 2024年第5期16卷 832-842页

作者： Elisa carolina Lange Pabulo Henrique Rampelotto Larisse Longo Laura Bainy Rodrigues de Freitas carolina Uribe-Cruz Mario Reis Alvares-da-Silva Experimental Laboratory of Hepatology and Gastroenterology Hospital de Clínicas de Porto AlegrePorto Alegre 90035-007Brazil Graduate Program in Gastroenterology and Hepatology Universidade Federal do Rio Grande do SulPorto Alegre 90035-007Brazil Bioinformatics and Biostatistics Core Facility Universidade Federal do Rio Grande do SulPorto Alegre 91501-970Brazil Graduate Program in Biological Sciences:Pharmacology and Therapeutics Universidade Federal do Rio Grande do SulPorto Alegre 90035-007Brazil Facultad de Ciencias de la Salud Universidad Católica de las MisionesPosadasMisiones 3300Argentina Division of Gastroenterology Hospital de Clínicas de Porto AlegrePorto Alegre 90035-007RSBrazil Conselho Nacional de Desenvolvimento Científico e Tecnológico(CNPq)researcher Brasília 71605-001Brazil

BACKGROUND Metabolic-dysfunction associated steatotic liver disease(MASLD)is a hepatic manifestation of metabolic syndrome.Studies suggest ornithine aspartate(LOLA)as drug therapy.AIM To analyze the influence of LOLA intake on gut microbiota using a nutritional model of MASLD.METHODS Adult male Sprague Dawley rats were randomized into three groups:Control(10 rats fed with a standard diet),MASLD(10 rats fed with a high-fat and choline-deficient diet),and LOLA(10 rats receiving 200 mg/kg/d LOLA,after the 16th week receiving high-fat and choline-deficient diet).After 28 wk of the experiment,animals were euthanized,and feces present in the intestine were collected.Following fecal DNA extraction,the V4 region of the 16S rRNA gene was amplified followed by sequencing in an Ion S5™system.RESULTS Alpha and beta diversity metrics were comparable between MASLD and LOLA.3 OTUs were differentially abundant between MASLD and LOLA,which belong to the species Helicobacter rodentium,Parabacteroides goldsteinii,and Parabacteroides distasonis.The functional prediction provided two different metabolic profiles between MASLD and LOLA.The 9 pathways differentially abundant in MASLD are related to a change in energy source,adenosine/purine nucleotides degradation as well as guanosine and adenosine deoxyribonucleotides biosynthesis.The 14 pathways differentially abundant in LOLA are associated with four major metabolic functions primarily influenced by L-aspartate,including tricarboxylic acid cycle pathways,purine/guanosine nucleotides biosynthesis,pyrimidine ribonucleotides biosynthesis and salvage as well as lipid IVA biosynthesis.CONCLUSION Although LOLA had no influence on alpha and beta diversity in this nutritional model of MASLD,it was associated with changes in specific gut microbes and their related metabolic pathways.

关键词： Animal model Gut microbiota Metabolic-associated steatotic liver disease Metabolic prediction Ornithine aspartate

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Review of the Cretaceous avian diversity of Antarctica:a changing scenario for the evolution of early Neornithine birds

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Advances in Polar Science 2024年第1期35卷 1-13页

作者： carolina ACOSTA HOSPITALECHE Facundo IRAZOQUI Paula BONA Ariana PAULINA-CARABAJAL División Paleontología de Vertebrados Museo de La PlataFacultad de Ciencias Naturales y MuseoUniversidad Nacional de La PlataPaseo del Bosque s/nLa Plata B1900FWAArgentina Consejo Nacional de Investigaciones Científicas y Técnicas(CONICET) Buenos Aires C1425FQBArgentina División Paleontología Vertebrados Museo de La Plata-Anexo ⅡFacultad de Ciencias Naturales y MuseoUniversidad Nacional de La PlataCalles 122 y 60La Plata B1900FWAArgentina Instituto de Investigaciones en Biodiversidad y Medioambiente(INIBIOMA) Consejo Nacional de Investigaciones Científicas y Técnicas-Universidad Nacional del ComahueSan Carlos de Bariloche R8400GAMArgentina

The worldwide record of Cretaceous Neornithes and Neornithine-like birds is both controversial and poorly understood.However,in recent years,the Antarctic continent has yielded a substantial number of Maastrichtian avian specimens,contributing significantly to our understanding of the early evolution of this group.Simultaneously,the keen interest and collaborative efforts of various paleornithologists have resulted in a wealth of knowledge,which we have thoroughly reviewed,updated,and discussed in the context of recent discoveries.

关键词： Maastrichtian Antarctic Peninsula Vega Island Seymour(Marambio)Island Neornithes birds

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Increasing dietary fiber intake for type 2 diabetes mellitus management: A systematic review

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World Journal of Diabetes 2024年第5期15卷 1001-1010页

作者： Douglas Nitzke Juliana Czermainski carolina Rosa Chaline Coghetto Sabrina Alves Fernandes Randhall B Carteri Department of Nutrition Centro Universitário CESUCACachoeirinha 94935-630Brazil Department of Hepatology Universidade Federal de Ciências da Saúde de Porto AlegrePorto Alegre 90430-080Brazil Postgraduate Program in Hepatology Universidade Federal de Ciências da Saúde de Porto AlegrePorto Alegre 90050-170Brazil Postgraduate Program in Hepatology Federal University of Health Sciences of Porto Alegre(UFCSPA)Porto Alegre 90050-170Brazil

BACKGROUND Type 2 diabetes is a chronic,non-communicable disease with a substantial global impact,affecting a significant number of individuals.Its etiology is closely tied to imbalanced dietary practices and sedentary lifestyles.Conversely,increasing die-tary fiber(DF)intake has consistently demonstrated health benefits in numerous studies,including improvements in glycemic control and weight management.AIM To investigate the efficacy of DF interventions in the management of type 2 diabetes mellitus(T2DM).METHODS A systematic literature review was conducted to explore the association between DF intake and the management of T2DM.Following the inclusion and exclusion criteria,a total of 26 studies were included in this review.RESULTS The main strategies implied to increased DF intake were:High DF diet plus acarbose(2 studies);DF supplements(14 studies);and high DF diets(10 studies).Overall,most studies indicated that increased DF intake resulted in im-provements in glycemic control and weight management in T2DM patients.CONCLUSION DF represents a valuable strategy in the treatment of type 2 diabetes,improving health outcomes.DF intake offers the potential to improve quality of life and reduce complications and mortality associated with diabetes.Likewise,through supplements or enriched foods,DF contributes significantly to the control of several markers such as HbA1c,blood glucose,triglycerides,low-density lipoprotein,and body weight.

关键词： Type 2 diabetes mellitus Soluble fibers Insoluble fibers Probiotics Blood glucose Nutrition

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Hypothalamic circuits and aging:keeping the circadian clock updated

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Neural Regeneration Research 2024年第9期19卷 1919-1928页

作者： Rosa Vázquez-Lizarraga Lucia Mendoza-Viveros carolina Cid-Castro Sareni Ruiz-Montoya Erick Carreño-Vázquez Ricardo Orozco-Solis Instituto Nacional de Medicina Genómica(INMEGEN) México CityMéxico Centro de Investigacíon sobre el Envejecimiento Centro de Investigacíon y de Estudios Avanzados(CIE-CINVESTAV)México CityMéxico Instituto de Investigaciones Biomédicas Universidad Nacional Autónoma de México UNAMMéxico CityMéxico

Over the past century,age-related diseases,such as cancer,type-2 diabetes,obesity,and mental illness,have shown a significant increase,negatively impacting overall quality of life.Studies on aged animal models have unveiled a progressive discoordination at multiple regulatory levels,including transcriptional,translational,and post-translational processes,resulting from cellular stress and circadian derangements.The circadian clock emerges as a key regulator,sustaining physiological homeostasis and promoting healthy aging through timely molecular coordination of pivotal cellular processes,such as stem-cell function,cellular stress responses,and inter-tissue communication,which become disrupted during aging.Given the crucial role of hypothalamic circuits in regulating organismal physiology,metabolic control,sleep homeostasis,and circadian rhythms,and their dependence on these processes,strategies aimed at enhancing hypothalamic and circadian function,including pharmacological and non-pharmacological approaches,offer systemic benefits for healthy aging.Intranasal brain-directed drug administration represents a promising avenue for effectively targeting specific brain regions,like the hypothalamus,while reducing side effects associated with systemic drug delivery,thereby presenting new therapeutic possibilities for diverse age-related conditions.

关键词： aging astrocytes cellular stress responses circadian clock hypothalamus intranasal drug administration metabolic control nutrient sensor SIRT1 sleep homeostasis

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