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Can testosterone therapy be offered to men on active surveillance for prostate cancer？ Preliminary results

Asian Journal of Andrology 2016年第1期18卷 16-20页

作者： Ravi Kacker Mariam Hult ignacio f san francisco William P Conners Pablo A Rojas William C Dewolf Abraham Morgentaler Men's Health Boston Brookline MA USA Pontifical Catholic University of Chile Santiago Chile Department of Urology Beth Israel Deaconess Medical Center Boston MA USA

This report presents our experience with T therapy in a cohort of T-deficient men on active surveillance （AS） for Gleason 3 ＋ 3 and Gleason 3 ＋ 4 prostate cancer （PCa）. A retrospective chart review identified 28 men with T deficiency who underwent T therapy （T group） for at least 6 months while on AS for PCa. A comparison group of 96 men on AS for PCa with untreated T deficiency （no-T group） was identified at the same institution. The AS protocol followed a modified Epstein criteria and allowed inclusion of men with a single core of low-volume Gleason 3 ＋ 4 PCa. Mean age was 59.5 and 61.3 years, and mean follow-up was 38.9 and 42.4 months for the T and no-T groups, respectively. Of all 28 men in the T group, 3 （10.7%） men developed an increase in Gleason score while on AS. Of 22 men in the T group with Gleason 3 ＋ 3 disease, 7 （31.8%） men developed biopsy progression including 3 men （13.6%） who developed Gleason 3 ＋ 4 PCa. Of 6 men with Gleason 3 ＋ 4 disease at baseline, 2 （33.3%） men developed an increase in tumor volume, and none developed upgrading beyond Gleason 3 ＋ 4. All 96 men in the no-T group had Gleason 3 ＋ 3 disease at baseline and, 43 （44.7%） developed biopsy progression, including 9 men （9.38%） with upgrading to Gleason 7 （3 ＋ 4）. Biopsy progression rates were similar for both groups and historical controls. Biopsy progression in men on AS appears unaffected by T therapy over 3 years. Prospective placebo-controlled trials of T therapy in T-deficient men on AS should be considered given the symptomatic benefits experienced by treated men.

关键词： active surveillance prostate cancer testosterone

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Challenges and improvement strategies in the hospitalization of chronic multimorbid patients

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World Journal of Clinical Cases 2025年第3期13卷 35-41页

作者： Andres fontalba-Navas francisco Pozo Muñoz Rogelio Garcia Cisneros Maria Jose Garcia Larrosa Maria del Mar Callejon Gil ignacio Garcia Delgado Maria Belen Jimenez Martinez Antequera Hospital Northern Málaga Integrated Healthcare AreaAntequera 29200AndalusiaSpain Department of Public Health and Psychiatry University of MálagaMálaga 29010Spain Antequera Hospital Northern Málaga Antequera Integrated Healthcare AreaAntequera 29200MálagaSpain

BACKGROUND Addressing the growing challenge of hospitalizing chronic multimorbid patients,this study examines the strain these conditions impose on healthcare systems at a local level,focusing on a pilot *** diseases and complex patients require comprehensive management strategies to reduce healthcare burdens and improve patient *** proven effective,this pilot model has the potential to be replicated in other healthcare settings to enhance the management of chronic multimorbid *** To evaluate the effectiveness of the high complexity unit(HCU)in managing chronic multimorbid patients through a multidisciplinary care model and to compare it with standard hospital *** The study employed a descriptive longitudinal approach,analyzing data from the Basic Minimum Data Set(BMDS)to compare hospitalization variables among the HCU,the Internal Medicine Service,and other services at Antequera Hospital throughout *** HCU,designed for patients with complex chronic conditions,integrates a patient-centered model emphasizing multidisciplinary care and continuity *** The study employed a descriptive longitudinal approach,analyzing data from the BMDS to compare hospitalization variables among the HCU,the Internal Medicine Service,and other services at Antequera Hospital throughout *** HCU,designed for patients with complex chronic conditions,integrates a patient-centered model emphasizing multidisciplinary care and continuity *** This study demonstrates the effectiveness of the HCU in managing patients with complex chronic diseases through a multidisciplinary *** coordinated care provided by the HCU results in improved patient outcomes,reduced unnecessary hospitalizations,and better management of patient *** superiority of the HCU compared to standard care is evident in key outcomes such as fewer readmissions and higher patient satisfaction,reinforcing its value as a model of ca

关键词： High complexity unit Chronic multimorbidity Patient-centered care Integrated care Healthcare management

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Generating native user interfaces for multiple devices by means of model transformation

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frontiers of Information Technology & Electronic Engineering 2015年第12期16卷 995-1017页

作者： ignacio MARIN francisco ORTIN German PEDROSA Javier RODRIGUEZ Department of Research and Development CTIC Foundation Department of Computer Science University of Oviedo

In the last years, the types of devices used to access information systems have notably increased using different operating systems, screen sizes, interaction mechanisms, and software features. This device fragmentation is an important issue to tackle when developing native mobile service front-end applications. To address this issue,we propose the generation of native user interfaces(UIs) by means of model transformations, following the modelbased user interface(MBUI) paradigm. The resulting MBUI framework, called LIZARD, generates applications for multiple target platforms. LIZARD allows the definition of applications at a high level of abstraction, and applies model transformations to generate the target native UI considering the specific features of target platforms. The generated applications follow the UI design guidelines and the architectural and design patterns specified by the corresponding operating system manufacturer. The objective is not to generate generic applications following the lowest-common-denominator approach, but to follow the particular guidelines specified for each target device. We present an example application modeled in LIZARD, generating different UIs for Windows Phone and two types of Android devices(smartphones and tablets).

关键词： Model-to-model transformation Native user interfaces Model-based user interfaces Model-driven engineering

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Splenic rupture following colonoscopy

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World Journal of Gastroenterology 2008年第41期14卷 6410-6412页

作者： Juan francisco Guerra ignacio san francisco fernando Pimentel Luis Ibanez Departamento de Cirugía Digestiva Pontificia Universidad Católica de Chile Marcoleta 367

Colonoscopy is a safe and routinely performed diagnostic and therapeutic procedure for different colorectal diseases. Although the most common complications are bleeding and perforation, extracolonic or visceral injuries have also been described. Splenic rupture is a rare complication following colonoscopy, with few cases reported. We report a 60-year-old female who presented to surgical consultation 8 h after a diagnostic colonoscopy. Clinical, laboratory and imaging findings were suggestive for a massive hemoperitoneum. At surgery, an almost complete splenic disruption was evident, and an urgent splenectomy was performed. After an uneventful postoperative period, she was discharged home. Splenic injury following colonoscopy is considered infrequent. Direct trauma and excessive traction of the splenocolic ligament can explain the occurrence of this complication. Many times the diagnosis is delayed because the symptoms are due to colonic insuffl ation, so the most frequent treatment is an urgent splenectomy. A high index of suspicion needs an early diagnosis and adequate therapy.

关键词： Colonoscopy Splenic injury Splenic rupture Splenectomy

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Quantifying local fire regimes using the Landsat data-archive:a conceptual framework to derive detailed fire pattern metrics from pixel-level information

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International Journal of Digital Earth 2019年第5期12卷 544-565页

作者： ignacio san-Miguel David W.Andison Nicholas C.Coops Integrated Remote Sensing Studio Department of Forest Resources ManagementUniversity of British ColumbiaVancouverBCCanada Bandaloop Landscape-Ecosystem Services North VancouverBCCanada

free and open access to the Landsat archive has enabled the detection and delineation of an unprecedented number of fire events across the *** the availability and potential of these data,few studies have analysed residual vegetation patterns and/or partial mortality of fire across the Canadian boreal forest,and those available,are either incomplete or ***,they all differ in the methods and spatial language,which makes it difficult for managers to interpret fire patterns over large *** is an urgent need for methods to help unify fire pattern observations across the Canadian boreal *** study explores the capacity of the Landsat data archive when coupled with a recently developed fire mapping approach and a robust spatial language to characterize and compare tree mortality patterns across the boreal plains ecozone,*** 507 fires 2.5 Mha mapped,this study represents the most comprehensive analysis of mortality patterns for study *** from this demonstration generated an accurate characterization of the fire patterns the various ecoregions based on seven key fire *** comparison between ecoregions revealed differences in the amount of residual vegetation,which in turn suggested various climate,topography and/or vegetation ecosystem drivers.

关键词： fire emulation historical range of variability landscape metrics fire patterns disturbance-based management

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Matrix metalloproteinases and their expression in mammary gland

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Cell Research 1998年第3期8卷 187-194页

作者： URIA JOSE A ZENA WERB(Department of Anatomy, University of California san francisco, CA 94143-0452, USA) Department of Anatomy University of California San Francisco CA USA

The matrix metalloproteinases (MMPs) are a family of zinc-dependent endopeptidases that play a key role in both normal and pathological processes involving tissue remodeling events. The expression of these proteolytic enzymes is highly regulated by a balance between extracellular matrix (ECM) deposition and its degradation, and is controlled by growth factors, cytokines, hormones, as well as interactions with the ECM macromolecules. furthermore, the activity of the MMPs is regulated by their natural endogenous inhibitors, which are members of the tissue inhibitor of metalloproteinases (TIMP) family. In the normal mammary gland, MMPs are expressed during ductal development, lobulo-alveolar development in pregnancy and involution after lactation. Under pathological conditions, such as tumorigenesis, the dysregulated expression of MMPs play a role in tumor initiation, progression and malignant conversion as well as facilitating invasion and motastasis of malignant cells through degradation of the ECM and basement membranes. Matrix metalloproteinases and their expression in mammary gland

关键词： Matrix metalloproteinases ECM cancer progression mammary gland

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A review of Helicobacter pylori diagnosis, treatment, and methods to detect eradication

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World Journal of Gastroenterology 2014年第6期20卷 1438-1449页

作者： Elvira Garza-González Guillermo ignacio Perez-Perez Héctor Jesús Maldonado-Garza francisco Javier Bosques-Padilla Servicio de Gastroenterología y Departamento de Patología Clínica Hospital Universitario "Dr. José Eleuterio González" Universidad Autónoma de Nuevo León Departments of Medicine and Microbiology New York University School of Medicine

Helicobacter pylori (H. pylori) affects nearly half of the world’s population and, thus, is one of the most frequent and persistent bacterial infections worldwide. H. pylori is associated with peptic ulcer disease, gastric ulcers, mucosa-associated lymphoid tissue lymphoma, and gastric cancer. Various diagnostic methods exist to detect infection, and the choice of one method or another depends on several factors, such as accessibility, advantages and disadvantages of each method, cost, and the age of patients. Once H. pylori infection is diagnosed, the clinician decides whether treatment is necessity, according to the patient’s clinical condition. Typically, eradication of H. pylori is recommended for treatment and prevention of the infection. Cure rates with the standard triple therapy are acceptable, and effective quadruple therapies, sequential therapies, and concomitant therapies have been introduced as key alternatives to treat H. pylori infection. In this work, we review the main diagnostic methods used to identify H. pylori infection and to confirm eradication of infection. In addition, key factors related to treatment are reviewed.

关键词： Diagnosis Helicobacter pylori Treatment Hybrid therapy Concomitant therapy Sequential therapy

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Endoscopic ultrasonography guided biliary drainage: Summary of consortium meeting, May 7^(th) , 2011, Chicago

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World Journal of Gastroenterology 2013年第9期19卷 1372-1379页

作者： Michel Kahaleh Everson LA Artifon Manuel Perez-Miranda Kapil Gupta Takao Itoi Kenneth f Binmoeller California Pacific Medical Center san francisco CA 94115 United States Marc Giovannini Division of Gastroenterology and Hepatology Weill Cornell Medical College New York NY 10021 United States Department of Gastroenterology University of So Paulo Medical School So Paulo 05403-000 Brazil Endoscopy Unit Hospital Universitario Rio Hortega 47012 Valladolid Spain Pancreatic Biliary Department Cedars-Sinai Medical Center Beverly Hills CA 90048 United States Department of Gastroenterology and Hepatology Tokyo Medical University Tokyo 160-0023 Japan Department of Gastroenterology Paolicalmettes Institute 13273 Marseille France

Endoscopic retrograde cholangiopancreatography (ERCP) has become the preferred procedure for biliary or pancreatic drainage in various pancreatico-biliary disorders. With a success rate of more than 90%, ERCP may not achieve biliary or pancreatic drainage in cases with altered anatomy or with tumors obstructing access to the duodenum. In the past those failures were typically managed exclusively by percutaneous approaches by interventional radiologists or surgical intervention. The morbidity associated was significant especially in those patients with advanced malignancy, seeking minimally invasive interventions and improved quality of life. With the advent of biliary drainage via endoscopic ultrasound (EUS) guidance, EUS guided biliary drainage has been used more frequently within the last decade in different countries. As with any novel advanced endoscopic procedure that encompasses various approaches, advanced endoscopists all over the world have innovated and adopted diverse EUS guided biliary and pancreatic drainage techniques. This diversity has resulted in variations and improvements in EUS Guided biliary and pancreatic drainage; and over the years has led to an extensive nomenclature. The diversity of techniques, nomenclature and recent progress in our intrumentation has led to a dedicated meeting on May 7 th , 2011 during Digestive Disease Week 2011. More than 40 advanced endoscopists from United States, Brazil, Mexico, Venezuela, Colombia, Italy, france, Austria, Germany, Spain, Japan, China, South Korea and India attended this pivotal meeting. The meeting covered improved EUS guided biliary access and drainage procedures, terminology, nomenclature, training and credentialing; as well as emerging devices for EUS guided biliary drainage. This paper summarizes the meeting's agenda and the conclusions generated by the creation of this consortium group.

关键词： Endoscopic ultrasound Biliary drainage Endosonography-guided cholangiopancreatography Endoscopic ultrasound guided Pancreatic drainage Endoscopic retrograde cholangiopancreatography

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Role of microRNAs in alcohol-induced liver disorders and non-alcoholic fatty liver disease

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World Journal of Gastroenterology 2018年第36期24卷 4104-4118页

作者： Jorge-Luis Torres ignacio Novo-Veleiro Laura Manzanedo Lucía Alvela-Suárez Ronald Macías francisco-Javier Laso Miguel Marcos Department of Internal Medicine University Hospital of SalamancaInstitute of Biomedical Research of Salamanca-IBSAL Spanish Working Group on Alcohol and Alcoholism Spanish Society of Internal Medicine Department of Internal Medicine University Hospital of Santiago de Compostela Department of Internal Medicine HM Rosaleda HospitalSantiago de Compostela Department of Medicine Faculty of MedicineUniversity of Salamanca

MicroRNAs(miRNAs) are small non-coding RNAs that regulate multiple physiological and pathological functions through the modulation of gene expression at the post-transcriptional level. Accumulating evidence has established a role for miRNAs in the development and pathogenesis of liver disease. Specifically, a large number of studies have assessed the role of miRNAsin alcoholic liver disease(ALD) and non-alcoholic fatty liver disease(NAfLD), two diseases that share common underlying mechanisms and pathological characteristics. The purpose of the current review is to summarize and update the body of literature investigating the role of miRNAs in liver disease. In addition, the potential use of miRNAs as biomarkers and/or therapeutic targets is discussed. Among all miRNAs analyzed, miR-34 a, miR-122 and miR-155 are most involved in the pathogenesis of NAfLD. Of note, these three miRNAs have also been implicated in ALD, reinforcing a common disease mechanism between these two entities and the pleiotropic effects of specific miRNAs. Currently, no single miRNA or panel of miRNAs has been identified for the detection of, or staging of ALD or NAfLD. While promising results have been shown in murine models, no therapeutic based-miRNA agents have been developed for use in humans with liver disease.

关键词： Alcohol use disorder Alcoholic liver disease Non-alcoholic fatty liver disease Steatosis Obesity miRNA Biomarkers

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COVID-19 pandemic,as experienced in the surgical service of a district hospital in Spain

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World Journal of Clinical Cases 2021年第23期9卷 6582-6590页

作者： francisco Javier Pérez Lara Maria Belen Jimenez Martinez francisco Pozo Muñoz Andres fontalba Navas Rogelio Garcia Cisneros Maria Jose Garcia Larrosa ignacio Garcia Delgado Maria del Mar Callejon Gil Department of Surgery Hopital de AntequeraAntequera 29200MálagaSpain North Malaga Healthcare District Hopital de AntequeraAntequera 29200MálagaSpain

The coronavirus disease 2019,which is caused by severe acute respiratory syndrome coronavirus 2,was first identified in December 2019 in Wuhan,China,and has since spread rapidly,evolving into a full-blown *** would like to report our experience after 1 year of this pandemic in the surgical service of a district hospital in *** have been many changes(including new protocols)that our service and the hospital have undergone,to adapt to the new *** believe that this experience can be useful for other professionals who have lived and are living a similar situation.

关键词： COVID-19 Hospital Experience Surgery Service Treatment

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