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Effect of Aspergillus niger prolyl endopeptidase in patients with celiac disease on a long-term gluten-free diet

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World Journal of Gastroenterology 2024年第11期30卷 1545-1555页

作者： Juan Pablo Stefanolo Verónica Segura Martina Grizzuti Abel Heredia Isabel Comino Ana Florencia Costa Roberto Puebla María Paz Temprano Sonia Isabel Niveloni Gabriel de Diego María E Oregui Edgardo gustavo Smecuol Mauricio C de Marzi Elena F Verdú Carolina Sousa Julio César Bai Small Bowel Section Department of MedicineGastroenterology Hospital of Buenos Aires“Dr.C.Bonorino Udaondo”Buenos Aires 1264Argentina Department of Microbiology and Parasitology Faculty of PharmacyUniversity of SevilleSeville 41080Spain Department of Medicine Dr.C.Bonorino Udaondo Gastroenterology HospitalBuenos Aires 1264Argentina Basic and Applied Research Group in Immunology and Bioactives(GIBAIB) Institute of Ecology and Sustainable Development(INEDES)National University of LujanLuján 6700Buenos AiresArgentina Department of Medicine Farncombe Family Digestive Health Research InstituteMcMaster UniversityHamilton L8S 4L8OntarioCanada Facultad de Medicina Universidad del SalvadorBuenos Aires C1051ABBArgentina

BACKGROUND The gluten-free diet(GFD)has limitations,and there is intense research in the development of adjuvant therapies.AIM To examine the effects of orally administered Aspergillus niger prolyl endopeptidase protease(AN-PEP)on inadvertent gluten exposure and symptom prevention in adult celiac disease(CeD)patients following their usual GFD.METHODS This was an exploratory,double-blind,randomized,placebo-controlled trial that enrolled CeD patients on a long-term GFD.After a 4-wk run-in period,patients were randomized to 4 wk of two AN-PEP capsules(GliadinX;AVI Research,LLC,United States)at each of three meals per day or placebo.Outcome endpoints were:(1)Average weekly stool gluten immunogenic peptides(GIP)between the run-in and end of treatments and between AN-PEP and placebo;(2)celiac symptom index(CSI);(3)CeD-specific serology;and(4)quality of life.Stool samples were collected for GIP testing by ELISA every Tuesday and Friday during run-ins and treatments.RESULTS Forty patients were randomized for the intention-to-treat analysis,and three were excluded from the per-protocol assessment.Overall,628/640(98.1%)stool samples were collected.GIP was undetectable(0.32μg/g)to potentially cause mucosal damage.Median GIP concentration in the AN-PEP arm was 44.7%lower than in the run-in period.One-third of patients exhibiting GIP>0.08μg/g during run-in had lower or undetectable GIP after AN-PEP treatment.Compared with the run-in period,the proportion of symptomatic patients(CSI>38)in the AN-PEP arm was significantly lower(P<0.03).AN-PEP did not result in changes in specific serologies.CONCLUSION This exploratory study conducted in a real-life setting revealed high adherence to the GFD.The AN-PEP treatment did not significantly reduce the overall GIP stool concentration.However,given the observation of a significantly lower prevalence of patients with severe symptoms in the AN-P

关键词： Celiac disease Aspergillus niger prolyl endoprotease Gluten immunogenic peptides Trial Symptoms Real-life trial

What is the prognosis of emphysematous pyelonephritis associated with extended-spectrum beta-lactamases producing microorganisms?

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Asian Journal of Urology 2022年第2期9卷 146-151页

作者： JoséIván Robles-Torres Marco Alberto Ocaña-Munguía Joségustavo Arrambide-Herrera Adrián Mauricio Martínez-Fernández Rodrigo Romero-Mata Lauro salvador Gómez-Guerra Urology Department Hospital Universitario"Dr.Jose´Eleuterio Gonza´lez"Universidad Auto´noma de Nuevo LeonMonterreyNuevo LeonMexico

Objective:To describe the microbiological characteristics in emphysematous pyelonephritis(EPN),demonstrate the frequency of extended-spectrum beta-lactamase(ESBL)microorganisms,and determine if these microorganisms are associated with the prognosis of patients with EPN.Methods:We conducted a retrospective study in patients with a diagnosis of EPN in a tertiary care hospital of the northeast region of Mexico during the period from January 2011 to January 2016.Clinical variables were analyzed to determine association with the presence of ESBL-producing microorganisms.Statistical significance was set with p<0.05.Results:A total of 63 patients were included;55(87.3%)of them were females,with a median age of 55(interquartile range:45-65)years.Conservative management was indicated in 38.1%;42.9%were treated with ureteral stent;12.7%with open or percutaneous drainage;15.8%with early nephrectomy;and 9.5%with delayed nephrectomy.Reported mortality was 13(20.6%)cases;23(36.5%)cases required admission to the intensive care unit.The most frequent microorganism isolated was Escherichia coli(n=34,53.9%).ESBL microorganisms were found in 31.7%of the population.No significant association of ESBL was found with admission to the intensive care unit,or with increased mortality.Conclusions:To our knowledge,this is the first study that evaluates ESBL microorganisms as a prognostic factor in EPN.Risk factors associated with a poor prognosis in patients with EPN have been described.The microbiological factors,specifically ESBL-producing bacteria,do not seem to influence in the prognosis of these patients.

关键词： Emphysematous pyelonephritis Extended spectrum betalactamase Mortality Intensive care unit admission

Optic Neuritis in Acute Neuroborreliosis (Lyme Disease) in the U.S.-Mexican Border: Case Report

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World Journal of Neuroscience 2016年第2期6卷 126-130页

作者： Ihtesham A. Qureshi Michael F. Maldonado gustavo J. Rodriguez salvador Cruz-Flores Alberto Maud Neurology Department Texas Tech University Health Sciences Center El Paso USA Ophthalmology Department Texas Tech University Health Sciences Center El Paso USA

Objective: We describe a patient diagnosed with acute neuroborreliosis presenting with anterior optic neuritis (papillitis) in a non-endemic region. Case Presentation: A 43-year-old previously healthy right handed man admitted due to an insidious onset of severe headache and spells of ascending paresthesias from his right foot into his right arm and face followed by speech arrest and clumsiness of his right hand. His neurologic exam was significant for somnolence, nuchal rigidity and Kernig and Brudzinski signs were present. MRI of the brain with gadolinium showed diffuse hyperintense signal involving the supra and infratentorial cortical sulci, with associated faint diffuse leptomeningeal enhancement, consistent most likely with diffuse leptomeningoencephalitis. EEG: normal. CSF VDRL was negative. Dilated fundus exam revealed mild optic nerve edema more significant to the left than to the right eye, confirmed and measured by spectral domain OCT (Optical Coherence Tomography). There was an evidence of posterior uveitis with an early vitreous hemorrhage superficial to the left optic nerve. Lyme disease serum antibody (IgM) Immunoblotting was positive in 2 bands confirming the diagnosis of neuroborreliosis. Conclusion: Optic nerve involvement in Lyme disease is an uncommon complication that should be confirmed by specific diagnostic criteria to establish its causal relation.

关键词： Optic Neuritis Lyme Disease Non-Endemic Papillitis

Current approach to treatment of minimal hepatic encephalopathy in patients with liver cirrhosis

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World Journal of Gastroenterology 2021年第22期27卷 3050-3063页

作者： Segundo Moran Marlene López-Sánchez María del Pilar Milke-García gustavo Rodríguez-Leal Laboratory of Hepatology Research Centro Médico NacionalSiglo XXIMexican Institute of Social SecurityMexico City 06720Mexico Division of Nutrition National Institute of NutritionSalvador ZubiránMexico City 14080Mexico

Minimal hepatic encephalopathy(MHE)corresponds to the earliest stage of hepatic encephalopathy(HE).MHE does not present clinically detectable neurological-psychiatric abnormalities but is characterized by imperceptible neurocognitive alterations detected during routine clinical examination via neuropsychological or psychometrical tests.MHE may affect daily activities and reduce job performance and quality of life.MHE can increase the risk of accidents and may develop into overt encephalopathy,worsening the prognosis of patients with liver cirrhosis.Despite a lack of consensus on the therapeutic indication,interest in finding novel strategies for prevention or reversion has led to numerous clinical trials;their results are the main objective of this review.Many studies address the treatment of MHE,which is mainly based on the strategies and previous management of overt HE.Current alternatives for the management of MHE include measures to maintain nutritional status while avoiding sarcopenia,and manipulation of intestinal microbiota with non-absorbable disaccharides such as lactulose,antibiotics such as rifaximin,and administration of different probiotics.This review analyzes the results of clinical studies that evaluated the effects of different treatments for MHE.

关键词： Minimal hepatic encephalopathy Sarcopenia Probiotics Non-absorbable disaccharides,Rifaximin L-ornithine-L-aspartate

Effect of Nanoparticles on Mechanical Properties of Cement-Sand Mortar Applications

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Advances in Chemical Engineering and Science 2017年第3期7卷 270-276页

作者： José salvador Cavazos gustavo González Oxana V. Kharissova Beatriz Ortega Laura Peñ a Mario Osorio Mauricio Garza-Castañ ón Universidad de Monterrey Physics and Mathematics Department Engineering and Technologies Division San Pedro Garza-García N.L.México Universidad Autónoma de Nuevo León Facultad de Ciencias Físico-Matemáticas Pedro de Alba S/N Ciudad Universitaria San Nicolás de los Garza N.L. Mexico

Cement-sand mortar is a construction material widely used;tile adhesive is one of the main applications where the compressive strength is the key performance metric. Nanoparticles like MWCNTs and HNTs are currently being used to improve the mechanical performance of the cement mortar due to their properties. The cost of MWCNTs has limited their application in the construction industry. This study focuses on the effect of two different concentrations of MWCNTs and HNTs in cement mortar;HNTs are proposed in this study to compare performance and cost overall benefits. A common problem with MWCNTs is agglomeration;to achieve a proper dispersion an ultrasonic processor was utilized. Mechanical properties of a cement mortar modified with nanoparticles were investigated with compression and bending tests on specimens performed at the age of 7 days. Results showed that concentrations of 0.1% of MWCNTs increase in compression strength by 56% and concentrations of 0.1% of HNTs performance increased by 31%, both compared to plain cement mortar.

关键词： Mechanical Properties Compressive Strength Cement Cement Manufacture

PPIs are not associated with a lower incidence of portal-hypertension-related bleeding in cirrhosis

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World Journal of Gastroenterology 2010年第46期16卷 5869-5873页

作者： Mauricio Garcia-Saenz-de-Sicilia Francisco Sanchez-Avila Norberto C Chavez-Tapia gustavo Lopez-Arce Sandra Garcia-Osogobio Roberto Ruiz-Cordero Felix I Tellez-Avila Department of Gastroenterology Instituto Nacional de Ciencias Medicas y Nutrición Salvador ZubiranMexico CityMexico Medica Sur Clinic and Fundation Endoscopy Department Instituto Nacional de Ciencias Medicas y Nutricion Salvador ZubiranMexico City14000Mexico

AIM:To determine if proton pump inhibitor use in cirrhotic patients with endoscopic findings of portal hypertension is associated with a lower frequency of gastrointestinal bleeding.METHODS:Patients with cirrhosis and endoscopic findings related to portal hypertension,receiving or not receiving proton pump inhibitor (PPI) therapy,were included retrospectively.We assigned patients to two groups:group 1 patients underwent PPI therapy and group 2 patients did not undergo PPI therapy.RESULTS:One hundred and five patients with a median age of 58 (26-87) years were included,57 (54.3%) of which were women.Esophageal varices were found in 82 (78%) patients,portal hypertensive gastropathy in 72 (68.6%) patients,and gastric varices in 15 (14.3%) patients.PPI therapy was used in 45.5% of patients (n=48).Seventeen (16.1%) patients presented with upper gastrointestinal bleeding;in 14/17 (82.3%) patients,bleeding was secondary to esophageal varices,and in 3/17 patients bleeding was attributed to portal hypertensive gastropathy.Bleeding related to portal hypertension according to PPI therapy occurred in 18.7% (n=9) of group 1 and in 14% (n=8) of group 2 (odds ratio:0.83,95% confidence interval:0.5-1.3,P=0.51).CONCLUSION:Portal hypertension bleeding is not associated with PPI use.These findings do not support the prescription of PPIs in patients with chronic liver disease with no currently accepted indication.

关键词： Drug prescription Liver cirrhosis Portal hypertension Proton pump inhibitors Upper gastrointestinal bleeding

Growth of PbS： Ni2＋ Nanocrystals Thin Films by Chemical Bath

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材料科学与工程（中英文A版） 2012年第5期2卷 410-422页

作者： Melissa Chavez Portillo Javier Martinez Juarez gustavo Abarca Avila Marcial Zamora Tototzintle MacarioMartinez Barragan Jorge. R. Cema Martin Lazcano Hernandez salvador Rosas Castilla Brenda CrespoSnchez Andrea Celeste Palacios Lopez and Oscar Portillo Moreno CIDS-ICUAP Benemerita Universidad Autonoma de Puebla (BUAP) Mexico Facultad de Ciencias Quimicas Benemdrita Universidad Autonoma de Puebla (BUAP) Moxico.C. U. Puebla Moxico

Risk stratification and geographical mapping of Brazilian inflammatory bowel disease patients during the COVID-19 outbreak:Results from a nationwide survey

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World Journal of Gastroenterology 2021年第12期27卷 1226-1239页

作者： Natália Sousa Freitas Queiroz Fábio Vieira Teixeira Marina Pamponet Motta Liliana Andrade Chebli Adriano Akira Ferreira Hino Camilla de Almeida Martins Abel Botelho Quaresma Alexandre Augusto de Paula da Silva Adérson Omar Mourão Cintra Damião Rogerio Saad-Hossne Paulo gustavo Kotze Department of Gastroenterology University of São Paulo School of MedicineSão Paulo 05403-000SPBrazil IBD Unit Gastroenterology DepartmentGastrosaúde ClinicMarilia 17509190SPBrazil School of Medicine Federal University of BahiaSalvador 40020-025BHBrazil IBD Outpatient Clinics Universidade Federal de Juiz de ForaJuiz de Fora 36010-010MGBrazil Health Sciences Postgraduate Program Pontifícia Universidade Católica do Paraná(PUCPR)Curitiba 80440-220PRBrazil Departamento de Ciências da Saúde Universidade do Oeste de Santa Catarina(UNOESC)Joaçaba 89600-000SCBrazil Botucatu Medical School Paulista State University(UNESP)Botucatu 18600-050SPBrazil IBD Outpatient Clinics Pontificia Universidade Católica do Paraná(PUCPR)Curitiba 80440-220PRBrazil

BACKGROUND Coronavirus disease 2019(COVID-19)pandemic is still evolving globally,and Brazil is currently one of the most affected countries.It is still debated whether patients with inflammatory bowel disease(IBD)are at a higher risk for developing COVID-19 or its complications.AIM To assess geographical distribution of IBD patients at the highest risk and correlate these data with COVID-19 mortality rates in Brazil.METHODS The Brazilian IBD Study Group(Grupo de Estudos da Doença Inflamatória Intestinal do Brasil)developed a web-based survey adapted from the British Society of Gastroenterology guidelines.The included categories were demographic data and inquiries related to risk factors for complications from COVID-19.Patients were categorized as highest,moderate or lowest individual risk.The Spearman correlation test was used to identify any association between highest risk and mortality rates for each state of the country.RESULTS A total of 3568 patients(65.3%females)were included.Most participants were from the southeastern and southern regions of Brazil,and 84.1%were using immunomodulators and/or biologics.Most patients(55.1%)were at moderate risk,23.4%were at highest risk and 21.5%were at lowest risk of COVID-19 complications.No association between the proportion of IBD patients at highest risk for COVID-19 complications and higher mortality rates was identified in different Brazilian states(r=0.146,P=0.467).CONCLUSION This study indicates a distinct geographical distribution of IBD patients at highest risk for COVID-19 complications in different states of the country,which may reflect contrasting socioeconomic,educational and healthcare aspects.No association between high risk of IBD and COVID-related mortality rates was identified.

关键词： Crohn’s disease Colitis,Ulcerative COVID-19 Inflammatory bowel disease Brazil

Prevalence of metabolic syndrome, obesity and diabetes type 2 in cryptogenic cirrhosis

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World Journal of Gastroenterology 2008年第30期14卷 4771-4775页

作者： Felix I Tellez-Avila Francisco Sanchez-Avila Mauricio García-Saenz-de-Sicilia Norberto C Chavez-Tapia Ada M Franco-Guzman gustavo Lopez-Arce Eduardo Cerda-Contreras Misael Uribe Department of Gastroenterology Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán

AIM: To evaluate the prevalence of metabolic syndrome (MS), obesity and type 2 diabetes mellitus (T2DM) in a group of Mexican Mestizo patients with cryptogenic cirrhosis (CC) and to compare this group with patients with cirrhosis secondary to other causes (disease controls). METHODS: Patients with CC, diagnosed between January, 1990 and April, 2005, were included in a retrospective study. Patients with cirrhosis caused by chronic hepatitis C, alcohol abuse or autoimmune hepatitis (AIH) served as disease controls. RESULTS: A total of 134 patients with CC were analyzed. Disease controls consisted of 81 patients with chronic hepatitis C, 33 with alcohol abuse and 20 with AIH. The median age of patients with CC was 57 years (range, 16-87); 83 (61.9%) patients were female; 53 (39.6%) were Child A, 65 (48.5%) Child B, and 16 (11.9%) were Child C cirrhosis. The prevalence of MS (29.1% vs 6%; P < 0.001), obesity (16.4% vs 8.2%; P = 0.04) and T2DM (40% vs 22.4%; P = 0.013) was higher in CC patients than in disease controls. There were no differences in sex, age or liver function tests between the two groups. CONCLUSION: The prevalence of MS, obesityand T2DM were higher in patients with CC than in patients with cirrhosis secondary to others causes. Our findings support the hypothesis that non-alcoholic steatohepatitis (NASH) plays an under-recognized role in CC.

关键词：隐原性肝硬化慢性肝炎代谢综合症肥胖糖尿病