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Endoscopic ultrasound-guided vs endoscopic retrograde cholangiopancreatography biliary drainage for obstructed distal malignant biliary strictures: A systematic review and meta-analysis

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World Journal of Gastrointestinal Endoscopy 2019年第4期11卷 281-291页

作者： fernanda p logiudice Wanderlei M Bernardo Facundo Galetti Vitor M Sagae Carolina O Matsubayashi Antonio C Madruga Neto Vitor O Brunaldi Diogo T H de Moura Tomazo Franzini Spencer Cheng Sergio E Matuguma Eduardo G H de Moura Gastrointestinal Endoscopy Unit Hospital das Clínicas da Faculdade de Medicina da Universidade de S?o Paulo Division of Gastroenterology Hepatology and Endoscopy Brigham and Women’s Hospital Harvard Medical School

BACKGROUND For palliation of malignant biliary obstruction(MBO), the gold-standard method of biliary drainage is endoscopic retrograde cholangiopancreatography(ERCp)with the placement of metallic stents. Endoscopic ultrasound(EUS)-guided drainage is an alternative that is typically reserved for cases of ERCp ***, however, there have been robust randomized clinical trials(RCTs)comparing EUS-guided drainage and ERCp as primary approaches to *** To compare EUS guidance and ERCp in terms of their effectiveness and safety in palliative biliary drainage for *** This was a systematic review and meta-analysis, in which we searched the MEDLINE, Excerpta Medica, and Cochrane Central Register of Controlled Trials databases. Only RCTs comparing EUS and ERCp for primary drainage of MBO were eligible. All of the studies selected provided data regarding the rates of technical and clinical success, as well as the duration of the procedure, adverse events, and stent patency. We assessed the risk of biases using the Jadad score and the quality of evidence using the Grading of Recommendations Assessment,Development and Evaluation *** The database searches yielded 5920 records, from which we selected 3 RCTs involving a total of 222 patients(112 submitted to EUS and 110 submitted to ERCp). In the EUS and ERCp groups, the rate of technical success was 91.96%n and 91.81%, respectively, with a risk difference(RD) of 0.00%(95%CI:-0.07, 0.07;p = 0.97; I^2 = 0%). The clinical success was 84.81% and 85.53% in the EUS and ERCp groups, respectively, with an RD of-0.01%(95%CI:-0.12, 0.10; p = 0.90; I^2 =0%). The mean difference(MD) for the duration of the procedure was-0.12%(95%CI:-8.20, 7.97; p = 0.98; I^2 = 84%). In the EUS and ERCp groups, there were14 and 25 adverse events, respectively, with an RD of-0.06%(95%CI:-0.23, 0.12; p= 0.54; I^2 = 77%). The MD for stent patency was 9.32%(95%CI:-4.53, 23.18; p =0.19; I^2 = 44%). The stent dysfunction rate was sig

关键词： Common bile duct neoplasms Endoscopic retrograde cholangiopancreatography Endosonography Ultrasonography Interventional/methods Endoscopic ultrasound Systematic review Meta-analysis

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Impacts of pI3K/protein kinase B pathway activation in reactive astrocytes: from detrimental effects to protective functions

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Neural Regeneration Research 2025年第4期20卷 1031-1041页

作者： Ramón pérez-Núñez María fernanda González Ana María Avalos Lisette Leyton Cellular Communication Laboratory Programa de Biología Celular y MolecularCenter for Studies on ExerciseMetabolism and Cancer(CEMC)Instituto de Ciencias Biomédicas(ICBM)Facultad de MedicinaUniversidad de ChileSantiagoChile Advanced Center for Chronic Diseases(ACCDiS) Faculty of Chemical and Pharmaceutical Sciences&Faculty of MedicineUniversidad de ChileSantiagoChile Instituto de Ciencias Biomédicas Facultad de Ciencias de la SaludUniversidad Autónoma de ChileSantiagoChile

Astrocytes are the most abundant type of glial cell in the central nervous *** injury and inflammation,astrocytes become reactive and undergo morphological and functional *** on their phenotypic classification as A1 or A2,reactive astrocytes contribute to both neurotoxic and neuroprotective responses,***,this binary classification does not fully capture the diversity of astrocyte responses observed across different diseases and *** analysis has revealed that reactive astrocytes have a complex landscape of gene expression profiles,which emphasizes the heterogeneous nature of their *** actively participate in regulating central nervous system inflammation by interacting with microglia and other cell types,releasing cytokines,and influencing the immune *** phosphoinositide 3-kinase(pI3K)/protein kinase B(AKT)signaling pathway is a central player in astrocyte reactivity and impacts various aspects of astrocyte behavior,as evidenced by in silico,in vitro,and in vivo *** astrocytes,inflammatory cues trigger a cascade of molecular events,where nuclear factor-κB serves as a central mediator of the pro-inflammatory ***,we review the heterogeneity of reactive astrocytes and the molecular mechanisms underlying their *** highlight the involvement of various signaling pathways that regulate astrocyte reactivity,including the pI3K/AKT/mammalian target of rapamycin(mTOR),αvβ3 integrin/pI3K/AKT/connexin 43,and Notch/pI3K/AKT *** targeting the inactivation of the pI3K/AKT cellular signaling pathway to control reactive astrocytes and prevent central nervous system damage,evidence suggests that activating this pathway could also yield beneficial *** dual function of the pI3K/AKT pathway underscores its complexity in astrocyte reactivity and brain function *** review emphasizes the importance of employing astrocyte-exclusive models to underst

关键词： inflammation integrins neuroprotective neurotoxic phosphatidylinositol 3-kinase reactive astrocytes signal transduction Thy-1(CD90)

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physico-chemical characterization of acid base disorders in patients with COVID-19:A cohort study

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World Journal of Nephrology 2024年第2期13卷 16-23页

作者： Sergio pinto de Souza Juliana R Caldas Marcelo Barreto Lopes Marcelo Augusto Duarte Silveira fernanda Oliveira Coelho Igor Oliveira Queiroz pedro Domingues Cury Rogério da Hora passos Department of Nephrology Hospital São RafaelSalvadorBA 41253190Brazil Department of Nephrology D’Or Institute for Research and Education(IDOR)SalvadorBA 41253190Brazil Faculty of Medicine Escola Bahiana de Medicina e Saúde Pública-EBMSPSalvadorBA 40290000Brazil Department of Intensive Care D’Or Institute for Research and Education(IDOR)SalvadorBA 41253190Brazil Hospital São Rafael D’Or Institute for Research and Education(IDOR)SalvadorBA 41253190Brazil Department of Intensive Care Unit Hospital Israelita Albert EinsteinSao PauloSP 05652900Brazil

BACKGROUND Acid-base imbalance has been poorly described in patients with coronavirus disease 2019(COVID-19).Study by the quantitative acid-base approach may be able to account for minor changes in ion distribution that may have been over-looked using traditional acid-base analysis *** a cohort of critically ill COVID-19 patients,we looked for an association between metabolic acidosis surrogates and worse clinical outcomes,such as mortality,renal dialysis,and length of hospital *** To describe the acid-base disorders of critically ill COVID-19 patients using Stewart’s approach,associating its variables with poor *** This study pertained to a retrospective cohort comprised of adult patients who experienced an intensive care unit stay exceeding 4 days and who were diagnosed with severe acute respiratory syndrome coronavirus 2 infection through a positive polymerase chain reaction analysis of a nasal swab and typical pulmonary involvement observed in chest computed tomography *** and clinical data were obtained from electronic *** variables were compared using Fisher’s exact *** data were presented as median and interquartile *** Mann-Whitney U test was used for *** In total,211 patients were *** mortality rate was 13.7%.Overall,149 patients(70.6%)presented with alkalosis,28 patients(13.3%)had acidosis,and the remaining 34 patients(16.2%)had a normal arterial pondus *** those presenting with acidosis,most had a low apparent strong ion difference(SID)(20 patients,9.5%).Within the group with alkalosis,128 patients(61.0%)had respiratory *** non-survivors were older,had more comorbidities,and had higher Charlson’s and simplified acute physiology score *** did not find severe acid-base imbalance in this *** analyzed Stewart’s variables(effective SID,apparent SID,and strong ion gap and the effect of albumin,lactate,phosphorus,and chloride)were not d

关键词： COVID-19 physicochemical approach Acid-base status Critically ill patients Acute respiratory syndrome

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Associations between health-related fitness and patient-reported symptoms in newly diagnosed breast cancer patients

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Journal of Sport and Health Science 2024年第6期13卷 851-862页

作者： Ki-Yong An fernanda Z.Arthuso Myriam Filion Spencer J.Allen Stephanie M.Ntoukas Gordon J.Bell Jessica McNeil Qinggang Wang Margaret L.McNeely Jeff K.Vallance Lin Yang S.Nicole Culos-Reed Leanne Dickau John R.Mackey Christine M.Friedenreich Kerry S.Courneya Faculty of Kinesiology Sportand RecreationCollege of Health SciencesUniversity of AlbertaEdmonton T6G 2H9Canada Department of Kinesiology School of Health and Human SciencesUniversity of North Carolina at GreensboroGreensboroNC 27412USA Department of Cancer Epidemiology and prevention Research Cancer Care AlbertaAlberta Health ServicesCalgary T2S 3C3Canada Faculty of Rehabilitation Medicine University of AlbertaEdmonton T6G 2H9Canada Faculty of Health Disciplines Athabasca UniversityAthabasca T9S 3A3Canada Department of Oncology Cumming School of MedicineUniversity of CalgaryCalgary T2N 4N1Canada Faculty of Kinesiology University of CalgaryCalgary T2N 1N4Canada Faculty of Medicine and Dentistry University of AlbertaEdmonton T6G 2H9Canada

Background:Newly diagnosed breast cancer patients experience symptoms that may affect their quality of life,treatment outcomes,and *** and managing breast cancer-related symptoms soon after diagnosis is *** purpose of this study was to investigate the associations between health-related fitness(HRF)and patient-reported symptoms in newly diagnosed breast cancer ***:This study utilized baseline data from the Alberta Moving Beyond Breast Cancer Cohort Study that were collected within 90 days of *** measures included peak cardiopulmonary fitness(peak volume of oxygen consumption(VO_(2peak))),maximal muscular strength and endurance,flexibility,and body *** measures included depression,sleep quality,and *** multivariable logistic regression was performed for ***:Of 1458 participants,51.5%reported poor sleep quality,26.5%reported significant fatigue,and 10.4%reported moderate *** multivariable-adjusted models,lower relative VO_(2peak)was independently associated with a greater likelihood of all symptom measures,including moderate depression(ppoor sleep quality(p=0.009),significant fatigue(p=0.008),any symptom(pple symptoms(ppeak)demonstrated threshold associations with all symptom measures such that all 3 lower quartiles exhibited similar elevated risk compared to the highest *** strength of the threshold associations varied by the symptom measure with odds ratios ranging from-1.5 for poor sleep quality to-3.0 for moderate depression and multiple ***,lower relative upper body muscular endurance was also independently associated with fatigue in a dose-response manner(p=0.001),and higher body weight was independently associated with poor sleep quality in an inverted U pattern(p=0.021).Conclusion:Relative VO_(2peak)appears to be a critical HRF component associated with multiple patient-reported symptoms in newly diag

关键词： Breast cancer Fatigue Depression Sleep quality Cardiorespiratory fitness

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Current and novel approaches in the pharmacological treatment of hepatocellular carcinoma

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World Journal of Gastroenterology 2023年第17期29卷 2571-2599页

作者： fernanda Villarruel-Melquiades María Eugenia Mendoza-Garrido Claudia M García-Cuellar Yesennia Sánchez-pérez Julio Isael pérez-Carreón Javier Camacho Departamento de Farmacología Centro de Investigación y de Estudios Avanzados del Instituto Politécnico Nacional(CINVESTAV-IPN)Mexico City 07360Mexico Departamento de Fisiología Biofísica y NeurocienciasCentro de Investigación y de Estudios Avanzados del Instituto Politécnico Nacional(CINVESTAVIPN)Mexico City 07360Mexico Subdirección de Investigación Básica Instituto Nacional de Cancerología(INCan)Mexico City 14080Mexico Instituto Nacional de Medicina Genómica Instituto Nacional de Medicina Genómica(INMEGEN)Mexico City 14610Mexico

Hepatocellular carcinoma(HCC)is one of the most lethal malignant tumours *** mortality-to-incidence ratio is up to 91.6%in many countries,representing the third leading cause of cancer-related *** drugs,including the multikinase inhibitors sorafenib and lenvatinib,are first-line drugs used in HCC ***,these therapies are ineffective in most cases due to late diagnosis and the development of tumour ***,novel pharmacological alternatives are urgently *** instance,immune checkpoint inhibitors have provided new approaches targeting cells of the immune ***,monoclonal antibodies against programmed cell death-1 have shown benefits in HCC *** addition,drug combinations,including first-line treatment and immunotherapy,as well as drug repurposing,are promising novel therapeutic ***,we review the current and novel pharmacological approaches to fight *** studies,as well as approved and ongoing clinical trials for liver cancer treatment,are *** pharmacological opportunities analysed here should lead to significant improvement in HCC therapy.

关键词： Liver cancer Systemic therapy Immunotherapy Drug repurposing Drug combinations Hepatocellular carcinoma

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