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Hemoconcentration is a poor predictor of severity in acute pancreatitis

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World Journal of Gastroenterology 2005年第44期11卷 7018-7023页

作者： José M.Remes-Troche Andrés Duarte-Rojo Gustavo Morales guillermo robles-Díaz Department of Gastroenterology

AIM： To determine whether the hematocrit （Hct） at admission or at 24 h after admission was associated with severe acute pancreatitis （AP）, organ failure （OF）, and pancreatic necrosis. METHODS： A total of 336 consecutive patients with a first AP episode were studied. Etiology, Hct values at admission and at 24 h, development of severe AP according to Atlanta＇s criteria, pancreatic necrosis, OF and mortality were recorded. Hemoconcentration was defined as Hct level 〉44% for males and 〉40% for females. The t-test and ;x^2 test were used to assess the association of hemoconcentration to the severity, necrosis and OF. Diagnostic accuracy was also determined. RESULTS： Biliary disease was the most frequent etiology （n = 148）. Mean Hct levels at admission were 41±6% for females and 46±7% for males （P〈0.01）. Seventyeight （23%） patients had severe AP, and OF developed in 45 （13%） patients. According to contrast-enhanced computed tomography scan, 36% （54/150） patients showed pancreatic necrosis. Hct levels were elevated in 58% （55/96） and 61% （33/54） patients with interstitial and necrotizing pancreatitis, respectively. Neither Hct levels at admission nor hemoconcentration at 24 h were associated with the severity, necrosis or OF. Sensitivity, specificity and positive predictive values for both determinations were very low; and negative predictive values were between 61% and 86%, being the highest value for OF. CONCLUSION： Hct is not a useful marker to predict a worse outcome in acute pancreatitis. In spite of the high negative predictive value of hemoconcentration, the prognosis gain is limited due to an already high incidence of mild disease.

关键词： Acute pancreatitis Hernatocrit Hemoconcentration Severity Necrosis

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World Journal of Gastroenterology 2006年第27期12卷 4392-4396页

作者： Andrés Duarte-Rojo Ana Lezama-Barreda María Teresa Ramírez-Iglesias Mario Peláez-Luna guillermo robles-Díaz Department of Internal Medicine Vasco de Quiroga 15Sectión ⅩⅥTlalpanCP 14000MéxicoDFMéxico Department of Gastroenterology Instituto Nacional de Ciencias Médicas y Nutrición Salvador ZubiránVasco de Quiroga 15Sección ⅩⅥTlalpanCP 14000MéxicoDFMéxico Department of Experimental Medicine Facultad de MedicinaUniversidad Nacional Autónoma de MéxicoHospital General de MéxicoDr. Balmis 148 PB Colonia DoctoresCP 06726MexicoDFMéxico

AIM： To evaluate the relationship between leptin and systemic inflammation in acute pancreatitis. METHODS： Consecutive patients with acute pancreatitis were included. Body mass index and serum samples were obtained at admission. Leptin, TNF-α, IL-6, -8 and -10 levels were determined by ELISA. Severity was defined according to Atlanta criteria. RESULTS： Fifty-two （29 females） patients were studied. Overall body mass index was similar between mild and severe cases, although women with severe pancreatitis had lower body mass index （P = 0.04） and men showed higher body mass index （P = 0.05）. No difference was found in leptin levels regarding the severity of pancreatitis, but higher levels tended to appear in male patients with increased body mass index and severe pancreatitis （P = 0.1）. A multivariate analysis showed no association between leptin levels and severity. The strongest cytokine associated with severity was IL-6. Correlations of leptin with another cytokines only showed a trend for IL-8 （P = 0.058）. CONCLUSION： High body mass index was associated with severity only in males, which may be related to android fat distribution. Serum leptin seems not to play a role on the systemic inflammatory response in acute pancreatitis and its association with severe outcome in males might represent a marker of increased adiposity.

关键词： Leptin Cytokines Obesity Acute pancreatitis Prognosis

SARS-CoV-2:Air pollution highly correlated to the increase in *** case of Guadalajara,Jalisco,Mexico

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Infectious Disease Modelling 2023年第2期8卷 445-457页

作者： Elizabeth Torres-Anguiano Itzel Sanchez-Lopez Angeles Garduno-robles Jorge David Rivas-Carrillo Edgar Alfonso Rivera-Leon Sergio Sanchez-Enríquez Luis Fernando Ornelas-Hernandez Fernando Zazueta Leon-Quintero Eduardo Narciso Salazar Leon-Quintero guillermo Enrique Juarez-Lopez Fernando Antonio Sanchez-Zubieta Mariana Ochoa-Bru Abraham Zepeda-Moreno Onkogenetik/Mexicana de Investigacion y Biotectogía S.A.de C.V GuadalajaraJaliscoMexico Unidad de Biología Molecular Investigacion y DiagnosticoHospital San JavierGuadalajaraJaliscoMexico Departamento de Fisiología Centro Universitario de Ciencias de la SaludUniversidad de GuadalajaraGuadalajaraJaliscoMexico Departamento de Biología Molecular y Genomica Centro Universitario de Ciencias de la SaludUniversidad de GuadalajaraGuadalajaraJaliscoMexico Departamento de Clínicas Centro Universitario de los AltosUniversidad de GuadalajaraTepatitlan de MorelosJaliscoMexico Departamento de Clínicas Medicas Centro Universitario de Ciencias de la SaludUniversidad de GuadalajaraGuadalajaraJaliscoMexico Servicio de Hemato-Oncología Pediatrica Hospital Civil de Guadalajara“Dr.Juan I.Menchaca”GuadalajaraJaliscoMexico Hospital Civil de Guadalajara“Fray Antonio Alcalde” GuadalajaraJaliscoMexico

Objectives:To determine whether air pollution or changes in SARS-CoV-2 lineages lead to an increase in ***:Descriptive statistics were used to calculate rates of infection(2020-2021).RT ePCR was used to compare viral loads from October 2020 to February *** sequencing(NGS)(n=92)was used to examine and phylogenetically map SARS-CoV-2 lineages.A correlative“air pollution/temperature”index(I)was developed using regression ***_(2.5),PM_(10),O_(3),NO_(2),SO_(2),and CO concentrations were analyzed and compared to the ***:The mortality rate during the last year was~32%.Relative SARS-CoV-2 viral loads increased in December 2020 and January *** revealed that approximately 80%of SARS-CoV-2 linages were B.1.243(33.7%),B1.1.222(11.2%),B.1.1(9%),B.1(7%),B.1.1.159(7%),and B.1.2(7%).Two periods were analyzed,the prehigh-and high-mortality periods and no significant lineage differences or new lineages were *** correlations of air pollution/temperature index values with mortality were found for IPM_(2.5) and IPM_(10).INO_(2).ISO_(2),and ICO but not for O_(3).Using ICO,we developed a model to predict mortality with an estimated variation of~±5 deaths per day.

关键词： Air pollution COVID-19 Guadalajara Mexico SARS-CoV-2 SARS-CoV-2 lineages

Effective use of FibroTest to generate decision trees in hepatitis C

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World Journal of Gastroenterology 2009年第21期15卷 2617-2622页

作者： Dana Lau-Corona Luís Alberto Pineda Héctor Hugo Avilés Gabriela Gutiérrez-Reyes Blanca Eugenia Farfan-Labonne Rafael Núez-Nateras Alan Bonder Rosalinda Martínez-García Clara Corona-Lau Marco Antonio Olivera-Martínez Maria Concepción Gutiérrez-Ruiz guillermo robles-Díaz David Kershenobich Department of Experimental Medicine School of MedicineUniversidad Nacional Autonoma de MexicoGeneral Hospital of Mexico Department of Computer Sciences Institute for Applied Mathematics and SystemsUniversidad Nacional Autonoma de Mexico Department of Gastroenterology Lomas Altas Clinic

AIM： To assess the usefulness of FibroTest to forecast scores by constructing decision trees in patients with chronic hepatitis C.METHODS： We used the C4.5 classification algorithm to construct decision trees with data from 261 patients with chronic hepatitis C without a liver biopsy. The FibroTest attributes of age, gender, bilirubin, apolipoprotein, haptoglobin, α2 macroglobulin, and γ-glutamyl transpeptidase were used as predictors, and the FibroTest score as the target. For testing, a 10-fold cross validation was used.RESULTS： The overall classification error was 14.9% （accuracy 85.1%）. FibroTest＇s cases with true scores of FO and F4 were classified with very high accuracy （18/20 for FO, 9/9 for FO-1 and 92/96 for F4） and the largest confusion centered on F3. The algorithm produced a set of compound rules out of the ten classification trees and was used to classify the 261 patients. The rules for the classification of patients in FO and F4 were effective in more than 75% of the cases in which they were tested.CONCLUSION： The recognition of clinical subgroups should help to enhance our ability to assess differences in fibrosis scores in clinical studies and improve our understanding of fibrosis progression,

关键词： Hepatitis C FibroTest Decision trees C4.5algorithm Non-invasive biomarkers

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

Diabetic gastroenteropathy:An underdiagnosed complication

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World Journal of Diabetes 2021年第6期12卷 794-809页

作者： Marcio JoséConcepción Zavaleta Jhean Gabriel Gonzáles Yovera Diego Martín Moreno Marreros Luciana del Pilar Rafael robles Kely Roxana Palomino Taype Karen Nohelly Soto Gálvez Luis Fernando Arriola Torres Julia Cristina Coronado Arroyo Luis Alberto Concepción Urteaga Division of Endocrinology Hospital Nacional Guillermo Almenara IrigoyenLima 12590Peru Division of Gastroenterology Hospital Nacional Guillermo Almenara IrigoyenLima 12590Peru Division of Medicine Universidad Nacional de TrujilloTrujillo 13011Peru Division of Endocrinology Hospital Nacional Dos de MayoLima 150101Peru Division of Endocrinology Instituto de Neurología y Endocrinología AvanzadaAndahuaylas 03700Peru Clinical Management Unit Hospital Nacional Guillermo Almenara IrigoyenLima 12590Peru Division of Neurology Instituto de Neurología y Endocrinología AvanzadaAndahuaylas 03700Peru Division of Obstetrics and Gynaecology Clínica VesalioLima 15036Peru Division of Neumology Hospital Regional Docente de TrujilloTrujillo 13011Peru

This article is an extensive review that provides an update on the pathophysiology,symptoms,diagnosis,and treatment of diabetic *** is no reported prevalence,but it has been described that patients with type 1 diabetes have a cumulative incidence at 10 years of 5.2%,and type 2 patients,1%.Also,in the group of type 1 diabetes,it has been observed that women are more likely to present this condition(5.8%vs 3.5%).Many factors are associate with its development(e.g.,hyperglycemia,vagal dysfunction,loss of expression of neural nitric oxide synthase in the myenteric plexus,alterations in the Cajal interstitial cell network,and oxidative stress).Gastrointestinal discomfort could be perceived 70% higher in diabetic patients,describing that 25%of diabetic patients experience gastrointestinal *** enteropathy could affect any portion of the gastrointestinal tract,but esophageal alterations were described in more than 60% of diabetic patients,also 60% of them present constipation,and 20%,*** emptying scintigraphy is useful to evaluate gastroparesis,therefore,gastric retention of more than 60%at 2 h has a sensitivity of 100% and specificity of 20% for diagnosis;however,other studies such as breath tests,with a sensitivity of 89% and a specificity of 80%,or the endoscopic capsule contribute to the *** is no cure;however,management must be multidisciplinary,focused on slowing the progression of diabetic gastroenteropathy,reducing symptoms,and restoring function;that includes nutritional recommendation,maintain glucose levels kept below 180 mg/dL,use of prokinetics,anti-emetics;nowadays,it has been special interest in surgical treatment,such as pyloroplasty,also gastric electrical stimulation appears to be another alternative.

关键词： Gastroenteropathy Gastroparesis Diabetes mellitus Complication Gastrointestinal disease Treatment