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High prevalence of hepatic steatosis and vascular thrombosis in COVID-19:A systematic review and meta-analysis of autopsy data

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World Journal of Gastroenterology 2020年第48期26卷 7693-7706页

作者： Luis Antonio Díaz francisco Idalsoaga Macarena Cannistra Roberto Candia Daniel Cabrera francisco barrera Alejandro Soza Rondell Graham Arnoldo Riquelme Marco Arrese Michael D Leise Juan Pablo Arab Department of Gastroenterology Escuela de MedicinaPontificia Universidad Católica de ChileSantiago 8320000Chile Department of Internal Medicine Pontificia Universidad Católica de ChileSantiago 8320000Chile School of Medicine Pontificia Universidad Católica de ChileSantiago 8320000Chile Facultad de Ciencias Médicas Universidad Bernardo O'HigginsSantiago 8320000Chile Department of Laboratory Medicine and Pathology Mayo Clinic RochesterMinnesotaMN 55902United States Católica de Chile Santiago 8320000Chile Division of Gastroenterology and Hepatology Mayo Clinic RochesterMinnesotaMN 55905United States

BACKGROUND Coronavirus disease 2019(COVID-19)disease can frequently affect the *** on hepatic histopathological findings in COVID-19 is *** To characterize hepatic pathological findings in patients with *** We conducted a systematic review with meta-analysis registered on PROSPERO(CRD42020192813),following PRISMA *** trials were those including patients of any age and COVID-19 diagnosis based on a molecular *** reports from deceased COVID-19 patients undergoing autopsy or liver biopsy were *** including less than ten patients were *** were pooled using random-effects models.Q statistic and I2 were used to assess heterogeneity and levels of evidence,*** We identified 18 studies from 7 countries;all were case reports and case series from *** the patients were over 15 years old,and 67.2%were *** performed a meta-analysis of 5 studies,including 116 *** prevalence estimates of liver histopathological findings were hepatic steatosis 55.1%[95%confidence interval(CI):46.2-63.8],congestion of hepatic sinuses 34.7%(95%CI:7.9-68.4),vascular thrombosis 29.4%(95%CI:0.4-87.2),fibrosis 20.5%(95%CI:0.6-57.9),Kupffer cell hyperplasia 13.5%(95%CI:0.6-54.3),portal inflammation 13.2%(95%CI:0.1-48.8),and lobular inflammation 11.6%(95%CI:0.3-35.7).We also identified the presence of venous outflow obstruction,phlebosclerosis of the portal vein,herniated portal vein,periportal abnormal vessels,hemophagocytosis,and *** We found a high prevalence of hepatic steatosis and vascular thrombosis as major histological liver *** frequent findings included portal and lobular inflammation and Kupffer cell hyperplasia or *** studies are needed to establish the mechanisms and implications of these findings.

关键词： Pathology SARS-CoV-2 COVID-19 Autopsies Liver Liver biopsies

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Impaired immune reaction and increased lactate and C-reactive protein for early prediction of severe morbidity and pancreatic fistula after pancreatoduodenectomy

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Hepatobiliary & Pancreatic Diseases International 2020年第1期19卷 58-67页

作者： Mario Rodriguez-Lopez francisco J.Tejero-Pintor Martin Bailon-Cuadrado Asterio barrera-Rebollo Baltasar Perez-Saborido David Pacheco-Sanchez General and Digestive Surgery Department Rio-Hortega University Hospital

Background: Prediction of complications after pancreatoduodenectomy (PD) remains of interest. Blood parameters and biomarkers during rst and second postoperative days (POD1, POD2) may be early indi- cators of complications. Methods: This case-control study included 50 patients. Baseline, POD1 and POD2 values of leukocytes, neutrophils, lymphocytes, platelets, hemoglobin, C-reactive protein (CRP), procalcitonin and arterial lactate were compared between individuals presenting Clavien ≥ III morbidity, pancreatic stula (PF) or clinically relevant PF (CRPF) and those without these morbidities. Common variables reaching signi cance were further analyzed in order to calculate a predictive score. Results: Severe morbidity, PF and CRPF rates were 28.0%, 26.0% and 14.0%, respectively. Patients with severe morbidity had lower leukocytes on POD2 (P=0.04). Patients with PF presented higher CRP on POD2 (P=0.001), higher lactate on POD1 (P=0.007) and POD2 (P=0.008), and lower lymphocytes on POD1 (P=0.007) and POD2 (P=0.008). Patients with CRPF had lower leukocytes and neutrophils on POD1 (P =0.048, P =0.038), lower lymphocytes on POD1 (P =0.001) and POD2 (P =0.003), and higher CRP on POD2 (P =0.001). Baseline parameters and procalcitonin obtained no statistical associations. Score was de ned according to lymphocytes on POD1 < 650/μL and CRP on POD2 ≥ 250 mg/L allocating patients in 3 risk categories. PF and CRPF rates were statistically higher as risk category increased (P<0.001). Receiver operating characteristic curves and Hosmer Lemeshow tests showed a good accuracy. Conclusions: Impaired immunological reaction during early postoperative period (lower leukocytes and, particularly, lymphocytes) in response to surgical aggression would favor complications after PD. Likewise, acidosis (higher arterial lactate) could behave as risk factor of PF. An elevated CRP on POD2 is also an early biomarker of PF. Our novel score based on postoperative lymphocyte count and CRP seems reliable

关键词： Pancreatoduodenectomy Morbidity Pancreatic fistula Biomarker Prediction Score

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Severe morbidity after pancreatectomy is accurately pre dicte d by preoperative pancreatic resection score(PREPARE): A prospective validation analysis from a medium-volume center

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Hepatobiliary & Pancreatic Diseases International 2018年第6期17卷 559-565页

作者： Mario Rodriguez-Lopez francisco J. Tejero-Pintor Baltasar Perez-Saborido Asterio barrera-Rebollo Martin Bailon-Cuadrado David Pacheco-Sanchez General and Digestive Surgery Department Rio-Hortega University Hospital

Background: Major morbidity in pancreatic surgery remains high. Different scores for predicting complications have been described. Preoperative pancreatic resection(PREPARE) score is based on objective preoperative variables and offers good predictive accuracy for Clavien ≥ III complications. This study aimed to validate this score and analyze other preoperative variables in a prospective study performed in a medium-volume center. Methods: A total of 50 pancreatic resections were included. Preoperative variables were registered and PREPARE was calculated. The main outcome was severe morbidity(Clavien ≥ III) up to 30 days after discharge. The secondary outcomes were length of stay(LOS) and readmission. Statistical validation was performed to compare severe morbidity rate among the scores categories. Association with other preoperative variables(not included in PREPARE) was also tested. Results: Of the 50 pancreatic resections, the severe morbidity was 34.0%, with median LOS of 11 days. Readmission rate was 25.5%. Severe morbidity rates according to PREPARE categories were 18.5% in lowrisk group, 41.7% in intermediate-risk group, and 63.6% in high-risk group, respectively( P = 0.023). The accuracy was 72%(Hosmer–Lemeshow, P = 0.86). ROC curve was obtained both for PREPARE score expressed as incremental values and categorized as the three risk groups, showing an area under curve(AUC) of 0.736(95% CI: 0.586–0.887; P = 0.007) and 0.712(95% CI: 0.555–0.869; P = 0.015), respectively. PREPARE was significant in multivariate analysis. Median LOS was statistically higher as PREPARE category increases(9, 11 and 15 days in low-, intermediate-and high-risk groups, respectively; P = 0.009). Readmission was not associated with any variables. Conclusions: PREPARE behaves as an independent risk factor for severe morbidity after pancreatic surgery. Score validation shows good accuracy prediction. Increasing PREPARE category is also associated with longer LOS.

关键词： Pancreatic surgery Morbidity Complications Preoperative pancreatic resection score Validation

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Preoperative pancreatic resection score:a preliminary prospective validation from Spain

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Hepatobiliary & Pancreatic Diseases International 2016年第6期15卷 667-668页

作者： Mario Rodriguez-Lopez Martin Bailon-Cuadrado francisco J Tejero-Pintor Baltasar Perez-Saborido Enrique Asensio-Diaz Asterio barrera-Rebollo General and Digestive Surgery Department Rio Hortega University HospitalDulzaina 247012ValladolidSpain

To the Editor：We read with outstanding interest the article by Celik et al. It is the first external description of the Hamburg＇s preoperative pancreatic resection （PREPARE） score since it was published in 2014 by Uzunoglu et al. According to the latter authors, it is necessary to stratify risk of major morbidity and mortality before performing a pancreatic resection, and PREPARE score is a simple index, validated in a multicenter cohort of patients undergoing this group of technically demanding procedures.

关键词： Preoperative pancreatic resection score

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Improving outcomes in pancreatic cancer: Key points in perioperative management

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World Journal of Gastroenterology 2014年第39期20卷 14237-14245页

作者： José M álamo Luis M Marín Gonzalo Suarez Carmen Bernal Juan Serrano Lydia barrera Miguel A Gómez Jordi Muntané francisco J Padillo Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREH o Ciberehd) Instituto de Salud Carlos Ⅲ 28029 Madrid Spain francisco J Padillo Department of General Surgery Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla 41013 Seville Spain

This review focused in the perioperative management of patients with pancreatic cancer in order to improve the outcome of the disease. We consider that the most controversial points in pancreatic cancer management are jaundice management, vascular resection and neo-adjuvant therapy. Preoperative biliary drainage is recommended only in patients with severe jaundice, as it can lead to infectious cholangitis, pancreatitis and delay in resection, which can lead to tumor progression. The development of a phase III clinical trial is mandatory to clarify the role of neo-adjuvant radiochemotherapy in pancreatic adenocarcinoma. Venous resection does not adversely affect postoperative mortality and morbidity, therefore, the need for venous resection should not be a contraindication to surgical resection in selected patients. The data on arterial resection alone, or combined with vascular resection at the time of pancreatectomy are more heterogeneous, thus, patient age and comorbidity should be evaluated before a decision on operability is made. In patients undergoing R0 resection, arterial resection can also be performed.

关键词： Pancreatic cancer Obstructive jaundice Preoperative drainage Neo-adjuvant therapy Vascular resection

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Ketamine anesthesia reduces intestinal ischemia/reperfusion injury in rats

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World Journal of Gastroenterology 2008年第33期14卷 5192-5196页

作者： Carlos Rodrigo Cámara francisco Javier Guzmán Ernesto Alexis barrera Andrés Jesús Cabello Armando Garcia Nancy Esthela Fernández Eloy Caballero Jesus Ancer Department of Physiology Universidad Autonoma de Nuevo Leon School of MedicineMonterrey Nuevo Leon 64460 Mexico Department of Pathology Universidad Autonoma de Nuevo Leon School of MedicineMonterrey Nuevo Leon 64460 Mexico

AIM: To investigate the effects of ketamine anesthesia on the motility alterations and tissue injury caused by ischemia/reperfusion in rats. METHODS: Thirty male Wistar rats weighing 200-250 g were used. Ischemia was induced by ob-structing blood flow in 25% of the total small intesti-nal length (ileum) with a vascular clamp for 45 min, after which either 60 min or 24 h of reperfusion was allowed. Rats were either anesthetized with pento-barbital sodium (50 mg/kg) or ketamine (100 mg/kg). Control groups received sham surgery. After 60 min of reperfusion, the intestine was examined for mor-phological alterations, and after 24 h intestinal basic electrical rhythm (BER) frequency was calculated, and intestinal transit determined in all groups. RESULTS: The intestinal mucosa in rats that were anesthetized with ketamine showed moderate altera-tions such as epithelial lifting, while ulceration and hemorrhage was observed in rats that received pento-barbital sodium after 60 min of reperfusion. Quantita-tive analysis of structural damage using the Chiu scaleshowed significantly less injury in rats that received ketamine than in rats that did not (2.35 ± 1.14 vs 4.58 ± 0.50, P < 0.0001). The distance traveled by a mark-er, expressed as percentage of total intestinal length, in rats that received pentobarbital sodium was 20% ± 2% in comparison with 25.9% ± 1.64% in rats that re-ceived ketamine (P = 0.017). BER was not statistically different between groups. CONCLUSION: Our results show that ketamine anesthesia is associated with diminished intestinal injury and abolishes the intestinal transit delay induced by ischemia/reperfusion.

关键词： Ischemia/Reperfusion Ketamine N-methyl-D-aspartate Intestinal motility Tissue damage

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First Detection of Human Polyomaviruses in HIV Patients with Suspected Neurological Disease in Montería, Colombia

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Modern Research in Inflammation 2015年第3期4卷 25-31页

作者： Vaneza Tique Samia barrera Salim Mattar Jorge Miranda francisco Camargo University of Cordoba Instituto de Investigaciones Biologicas del Tropico Córdoba Colombia Clinica Salud Social Sincelejo Sucre Clinica Zayma Intensive Care Unit Monteria Cordoba

Objective: The objective is to establish the presence of JC and/or BK polyomavirus in HIV patients with symptoms of encephalitis and/or meningitis. Methodology: From September 2009 to December 2011, a prospective study was conducted. 34 HIV patients with symptoms consistent with encephalitis and/or meningitis were included. The work was conducted in 3 hospitals in the city of Monteria. Viral DNA extraction was performed on samples of cerebrospinal fluid (CSF) using a commercial kit (Quiagen, USA). The detection of BKV and JCV was performed by multiplex real-time PCR (LightMix?, Roche Diagnostics, Germany) with primers specific for the short t antigen gene fragment, labeled probes and one internal control. Results: In 9 (26%) of 34 patients included in the study, JCV virus was detected;only 1 (3%) patient had coinfection with JCV/BKV. The mortality rate was 3%. The cytochemical examination of CSF in positive patients presented average values: 40.7 mg/dL glucose, 171.66 mg/dL protein, 19.8 mm3 leukocytes, and 109.8 mm3 erythrocytes. Conclusion: The findings demonstrate that JCV and BKV have a significant occurrence in HIV patients with CSF infections in Monteria.

关键词： Progressive Multifocal Leukoencephalopathy Meningitis Encephalopathy AIDS

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Mobility Habitus in the Literature From 2020 to 2024

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Journalism and Mass Communication 2024年第2期14卷 53-62页

作者： María del Rosario Molina González Cruz García Lirios Julio E Crespo Isabel Cristina Rincón Rodríguez Jorge Enrique Chaparro Medina francisco Rubén Sandoval Vázquez Enrique Martínez Muñoz JoséAlfonso Aguilar Fuentes Alfredo barrera Escobar Universidad de Sonora NavojoaMéxico Universidad de la Salud Ciudad de MexicoMéxico Universidad de Los Lagos OsornoChile Universidad de Santander UDES BucaramangaColombia Universidad de Investigación y Desarrollo UDI BucaramangaColombia Universidad Autónoma del Estado de Morelos CuernavacaMéxico Universidad Autónoma del Estado de Hidalgo PachucaMéxico Universidad Autónoma del Estado de México HuehuetocaMéxico Universidad Fidel Velazquez EdomexMéxico

The objective of the present work is modeling the mobility habitus in the public transport system with low Co2 emission mechanics in the center of *** this sense,a documentary work was carried out with a review of sources indexed to national repositories,using the Delphi technique for the content analysis and the specification of the model.A study was conducted with a selection of 100 students to establish the reliability,linearity,sphericity,adequacy,and validity of an instrument from which a relationship of dependence between income and mobility habitus was *** limits of the search,selection,and processing of information are recognized,and it is recommended to extend the research to international repositories,as well as to employ a more sophisticated technique.

关键词： spatiality habitus capacities model complexity

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Racial differences in prevalence and severity of non-alcoholic fatty liver disease

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World Journal of Hepatology 2021年第7期13卷 763-773页

作者： Maurizio Bonacini Farah Kassamali Swathi Kari Nieves Lopez barrera Mohamed Kohla Department of Gastroenterology and Hepatology California Pacific Medical CenterCalifornia Pacific Medical CenterSan FranciscoCA 94115United States Department of Gastroenterology and Hepatology California Pacific Medical CenterSan FranciscoCA 94115United States Department of Internal Medicine St.Mary's medical CenterSan FranciscoCA 94117United States Quest Clinical Research San FranciscoCA 94115United States Department of Hepatology National Liver InstituteMenoufiya UniversityShibin Al Kom 32511MenoufiyaEgypt

The aim of this review is to assess the evidence regarding racial differences in the prevalence and severity of nonalcoholic fatty liver disease(NAFLD).We reviewed the published literature that reported prevalence,severity,and genetic associations of NAFLD in different ethnic *** metabolic syndrome(MetS)has been associated with NAFLD,but each component of the MetS is present in various races in different percentages and their effect on NAFLD appears to be *** elevated triglyceride(TG)level seems to have the strongest association with *** latter is more prevalent in Hispanic patients;Blacks have lower TG levels and a lower NAFLD prevalence,compared to Caucasians or *** severity of liver fibrosis is lower in some,but not all biopsy-based studies of Black *** study has evaluated the severity of liver disease controlling for the individual components of MetS,especially *** racial differences in the prevalence of selected genetic polymorphisms,particularly PNPLA-3 and MBOAT7 have been documented,together with their effects on the prevalence of liver steatosis and *** on overall and liver mortality have found no significant differences according to race/ethnicity,with the possible exception of one paper reporting lower cirrhosis mortality in Black *** conclude that NAFLD is more prevalent in Hispanics and less in *** is supported by differences in key genetic polymorphisms associated with hepatic fat ***,there is presently insufficient evidence to firmly conclude that race,per se,plays a role in the development of liver fibrosis and its *** studies,appropriately controlled for diet,exercise,and individual MetS parameters are needed.

关键词： Race Ethnicity Nonalcoholic fatty liver disease Fatty liver disease Metabolic syndrome

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Presence of <i>Actinobacillus pleuropneumoniae, Streptococcus suis, Pasteurella multocida, Bordetella bronchiseptica, Haemophilus parasuis and Mycoplasma hyopneumoniae</i>in upper respiratory tract of swine in farms from Aguascalientes, Mexico

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Open Journal of Animal Sciences 2013年第2期3卷 132-137页

作者： Abraham Loera-Muro francisco J. Avelar-González Víctor M. Loera-Muro Mario Jacques Alma L. Guerrero-barrera Centro de Ciencias Básicas Universidad Autónoma de Aguascalientes Aguascalientes México Groupe de recherche sur les maladies infectieuses du porc Faculté de Médecine Vétérinaire Université de Montréal St-Hyacinthe Canada Laboratorio de Biología Celular y Tisular Departamento de Morfología Centro de Ciencias Básicas Universidad Autónoma de Aguascalientes Aguascalientes México

Respiratory diseases are one of the most important health problems in pig herds. The porcine respiratory disease complex (PRDC) is the term used to describe pneumonic diseases caused by multiple infectious agents that provoke weight loss in animals or death. In the PRDC multiple pathogens (bacteria and/or viruses) work in combination to induce this respiratory disease. Within this complex, Actinobacillus pleuropneumoniae, Streptococcus suis, Pasteurella multocida, Bordetella bronchiseptica, Haemophilus parasuis and Mycoplasma hyopneumoniae are the main bacterial pathogens involved in great economic losses to the swine industry. The aim of this work was to estimate the presence of A. pleuropneumoniae, S. suis, P. multocida, B. bronchiseptica, H. parasuis and M. hyopneumoniae in the upper respiratory tract of pigs in representative swine farms inAguascalientes,Mexico, using PCR technique. The study was performed in 14 swine farms. We obtained a total of 212 nasal swabs. Near 20% of samples were positive for A. pleuropneumoniae (located in the 79% of farms);17% were positive for S. suis (in 86% of farms), of these, 3% were S. suis serovar 2;30% were positive for H. parasuis (93% of farms);23% of the samples to P. multocida (in 79% of farms);and 19% to M. hyopneumoniae (in 64% of farms). B. bronchiseptica was not detected in this study. The results obtained show that bacterial pathogens of PRDC were present in the upper respiratory tract of pigs in all farms studied;therefore, these pathogens are widely disseminated in pig farms of Aguascalientes, Mexico.

关键词： Porcine Respiratory Disease Complex Actinobacillus pleuropneumoniae Streptococcus suis Pasteurella multocida Bordetella bronchiseptica Haemophilus parasuis Mycoplasma hyopneumoniae

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