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Clinical perspectives,assessment,and mechanisms of metabolicassociated fatty liver disease in patients with COVID-19

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World Journal of Gastroenterology 2021年第33期27卷 5502-5519页

作者： Alejandro Campos-Murguía Berenice M Román-Calleja JoséA González-Regueiro Ivonne Hurtado-Díaz-de-León Alberto Adrián Solís-Ortega Nayelli C Flores-garcía ignacio garcía-juárez Astrid Ruiz-Margáin Ricardo Ulises Macías-Rodríguez Department of Gastroenterology Instituto Nacional de Ciencias Médicas y Nutrición Salvador ZubiránMexico City 14080Mexico Liver Fibrosis and Nutrition Lab(LFNLab) MICTLÁN-Network(Mechanisms of Liver InjuryCell Death and Translational Nutrition in Liver Diseases-Research Network)Mexico City 14080Mexico

Metabolic diseases are highly prevalent worldwide and have been associated with adverse clinical outcomes,including mortality,in patients developing coronavirus disease(COVID-19).Because of the close relationship between metabolic diseases such as type 2 diabetes mellitus and obesity and the presence of metabolicassociated fatty liver disease(MAFLD),a high number of cases of patients affected by both MAFLD and COVID-19 would be expected,especially in highrisk *** studies have shown an increased risk of adverse clinical outcomes,viral shedding,and deep vein thrombosis,especially in patients with MAFLD-related liver *** predisposition to poor outcomes and severe acute respiratory syndrome coronavirus 2 infection in patients with MAFLD could be secondary to mechanisms common to both,including preexisting systemic chronic inflammation,endothelial dysfunction,and involvement of the renin-angiotensin *** of the increased risk of adverse outcomes,MAFLD should be screened in all patients admitted for *** computed tomography scans could be of help,assessment of liver fibrosis is also recommended,favoring noninvasive methods to limit the exposure of healthcare *** involvement in this population ranges from abnormalities in liver chemistry to hepatic steatosis in postmortem ***,preventive measures should be strongly advocated in patients already known to have MAFLD,including the use of telemedicine and vaccination in addition to general measures.

关键词： Metabolic-associated fatty liver disease COVID-19 Mortality Fibrosis Histology Epidemiology

Diagnosis and treatment of hepatocellular carcinoma: An update

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World Journal of Hepatology 2015年第3期7卷 362-376页

作者： Javier Tejeda-Maldonado ignacio garcía-juárez Jonathan Aguirre-Valadez Adrián González-Aguirre Mario Vilatobá-Chapa Alejandra Armengol-Alonso Francisco Escobar-Penagos Aldo Torre juan Francisco Sánchez-ávila Diego Luis Carrillo-Pérez Department of Internal Medicine Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán Department of Gastroenterology Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán Department of Interventional Radiology Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán Department of Transplantation Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán Department of Hematology and Oncology Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán

Hepatocellular carcinoma(HCC) is one of the most common malignancies leading to high mortality rates in the general population; in cirrhotic patients, it is the primary cause of death. The diagnosis is usually delayed in spite of at-risk population screening recommendations, i.e., patients infected with hepatitis B or C virus. Hepatocarcinogenesis hinges on a great number of genetic and molecular abnormalities that lead to tumor angiogenesis and foster their dissemination potential. The diagnosis is mainly based on imaging studies such as computed tomography and magnetic resonance, in which lesions present a characteristic classical pattern of early arterial enhancement followed by contrast medium "washout" in late venous phase. On occasion, when imaging studies are not conclusive, biopsy of the lesion must be performed to establish the diagnosis. The Barcelona Clinic Liver Cancer staging method is the most frequently used worldwide and recommended by the international guidelines of HCC management. Currently available treatments include tumor resection, liver transplant, sorafenib and locoregional therapies(alcoholization, radiofrequency ablation, chemoembolization). The prognosis of hepatocarcinoma is determined according to the lesion's stage and in cirrhotic patients, on residual liver function. Curative treatments, such as liver transplant, are sought in patients diagnosed in early stages; patients in more advanced stages, were not greatly benefitted by chemotherapy in terms of survival until the advent of target molecules such as sorafenib.

关键词： Hepatocellular carcinoma Surveillance Liver transplant Sorafenib Catheter ablation

Sound waves and solutions:Point-of-care ultrasonography for acute kidney injury in cirrhosis

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World Journal of Critical Care Medicine 2024年第2期13卷 83-92页

作者： David Aguirre-Villarreal Mario Andrés de Jesús Leal-Villarreal ignacio garcía-juárez Eduardo R Argaiz Abhilash Koratala Departamento de Gastroenterología Instituto Nacional de Ciencias Médicas y Nutrición Salvador ZubiránMexico City 14080Mexico Cardiología Instituto Nacional de Cardiología Ignacio ChávezMexico City 14080Mexico Unidad de Hepatología y Trasplante Departamento de GastroenterologíaInstituto Nacional de Ciencias Medicas y Nutricion Salvador ZubiranMexico City 14080Mexico Departamento de Nefrología y Metabolismo Mineral Instituto Nacional de Ciencias Médicas y Nutrición Salvador ZubiránMexico City 14080Mexico Tecnológico de Monterrey Escuela de Medicina y Ciencias de la SaludMexico City 64710Mexico Department of Nephrology Medical College of WisconsinMilwaukeeWI 53226United States

This article delves into the intricate challenges of acute kidney injury(AKI)in cirrhosis,a condition fraught with high morbidity and *** complexities arise from distinguishing between various causes of AKI,particularly hemodynamic AKI,in cirrhotic patients,who experience hemodynamic changes due to portal *** term"hepatocardiorenal syndrome"is introduced to encapsulate the intricate interplay among the liver,heart,and *** narrative emphasizes the often-overlooked aspect of cardiac function in AKI assessments in cirrhosis,unveiling the prevalence of cirrhotic cardiomyopathy marked by impaired diastolic *** conventional empiric approach involving volume expansion and vasopressors for hepatorenal syndrome is critically analyzed,highlighting potential risks and variable patient *** advocate for a nuanced algorithm for AKI evaluation in cirrhosis,prominently featuring point-of-care ultrasonography(POCUS).POCUS applications encompass assessing fluid tolerance,detecting venous congestion,and evaluating cardiac function.

关键词： Point-of-care ultrasonography Bedside ultrasound Cirrhosis Congestion Acute kidney injury Congestive nephropathy

Navigating medial patellotibial ligament reconstruction:Clinical perspectives and surgical strategies

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World Journal of Clinical Cases 2025年第1期13卷 6-10页

作者： juan Pablo Zicaro ignacio garcia-Mansilla Division of Knee Hospital Italiano de Buenos AiresBuenos Aires 1109Argentina

The surgical approach for patellar instability usually refers to reconstruction of the medial patellofemoral ligament associated with an osteotomy of the tibial tuberosity or a trochleoplasty when *** medial patellotibial ligament and the medial patellomeniscal ligament are secondary stabilizers of the *** this,both the medial patellotibial and patellofemoral ligaments aid in patellar rotation and tilt when the knee is flexed beyond 45°.The medial patellotibial ligament plays a particularly important role in the final stages of stretching in extension and between 40 degrees to 90 degrees of *** clinical relevance and surgical indications for medial patellotibial ligament reconstruction associated with medial patellofemoral ligament reconstruction are still *** editorial explores the surgical indications and clinical results for medial patellotibial ligament reconstruction to improve readers’understanding of this technique,especially because reported clinical outcomes have remained sparse.

关键词： Medial patellotibial ligament Patellar instability Reconstruction Surgical

Drought effects on the plasticity in vessel traits of two endemic Magnolia species in the tropical montane cloud forests of eastern Mexico

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Journal of Plant Ecology 2020年第3期13卷 331-340页

作者： Ernesto Chanes Rodríguez-Ramírez José Antonio Vázquez-garcía ignacio garcía-González Othón Alcántara-Ayala Isolda Luna-Vega Laboratorio de Biogeografía y Sistemática Departamento de Biología EvolutivaFacultad de CienciasUniversidad Nacional Autónoma de MéxicoMexico CityMexico Laboratorio de Ecosistemática Instituto de BotánicaDepartamento de Botánica y ZoologíaCentro Universitario de Ciencias Biológicas y AgropecuariasUniversidad de GuadalajaraJaliscoMexico Departamento de Botánica Escola Politécnica Superior de EnxeñaríaUniversidad de Santiago de CompostelaLugoSpain

Aims We aimed to evaluate how climatic fluctuations influence the plasticity of anatomical vessel traits and the width of annual tree-rings of two relict-endemic Mexican Magnolia ***,few studies have assessed the drought effect on vessel traits in tropical montane cloud trees of eastern *** Through digital images of growth rings,we assessed the tree radial growth rate,age of the trees and plasticity in vessel traits regarding climatic fluctuations of the Mexican Magnolia species *** compared vessel density,hydraulic diameter and percentage of conductive area in drought years(DY)and non-drought years(NDY)in two Mexican Magnolia *** Findings For the first time,the plasticity that occurs in porous wood vessel traits to long-term climatic fluctuations was analysed for two endangered Magnolia species(Magnolia vovidesii and ***)from two tropical montane cloud forests in *** found that temperature and precipitation were strongly associated with differences in tree-ring width when DY and NDY were *** analyses revealed that a high plasticity in vessel anatomy of diffuse-porous wood was related to temperature and/or water availability for both Magnolia species *** concluded that anatomical adaptations to DY resulted in a substantial reduction in vessel traits when compared with NDY,and that the plastic adaptations played an essential role in water transport and safety for the survival of the studied species during stressful long periods.

关键词： adaptability climate variability drought–growth relationship Magnolia schiedeana Magnolia vovidesii quantitative wood anatomy

Pharmacokinetics of sildenafil in children with pulmonary arterial hypertension

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World Journal of Pediatrics 2017年第6期13卷 588-592页

作者： Hugo juárez Olguín Hector Osnaya Martínez Carmen Flores Pérez Blanca Ramírez Mendiola Liliana Rivera Espinosa juan Luis Chávez Pacheco Janett Flores Pérez ignacio Mora Maga(n)a Laboratory of Pharmacology National Institute of PediatricsMexico CityMexico Department of Pharmacology Faculty of MedicineNational Autonomous University of MexicoMexico CityMexico Service of Cardiology National Institute of PediatricsMexico CityMexico Laboratory of Pharmacology National Institute of PediatricsMexico CityMexico Subdirection of Teaching and Educational Programming National Institute of PediatricsMexico CityMexico

Background:Recently,sildenafil was introduced to treat pulmonary arterial hypertension (PAH);however,there are currently few studies on the pharmacokinetics of sildenalfil in ***,we aimed to carry out a pharmacokinetic study of sildenafil in children with PAH using a single ***:Twelve children diagnosed with PAH,consisting of with ten males and two females,were recruited for the study after obtaining written consent from their parents or *** samples were obtained predose and at 0.25,0.5,1,2,4,8 and 12 hours after the oral administration of 1 mg/kg of sildenafil using an extemporal pediatric formulation developed in our *** samples were analyzed using a previously validated high performance liquid chromatography ***:A pharmacokinetic analysis using the WinNonlin 3.1 program that considered the Akaike information criterion (AIC) for sdecting a more adjustable model was *** following pharmacokinetic parameters were obtained:maximal concentration (Cmax):366+179 ng/mL,time to maximal concentration:0.92±0.30 hours,elimination half-life (t1/2):2.41±1.18 hours,total clearance (CLto/F):5.85±2.81 L/hour,volume of distribution (Vd/F):20.13±14.5 L,absorption rate constants (Ka):0.343 hour-1,elimination rate (Ke):0.35 hour-1,area under curve from zero to infinity:2061±618 ng/mL/*** data of all patients adjusted to the model of one compartment were corroborated using ***:The parameters Ka,Ke and t1/2 were found to be similar to those reported in adults;however,the values of Cmax and Vd/F were significantly *** on these findings,we propose that treatment regimen of sildenafil be adjusted in children with PAH.

关键词： pharmacokinetics pulmonary arterial hypertension sildenafil

Rat model of anal sphincter injury and two approaches for stem cell administration

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World Journal of Stem Cells 2018年第1期10卷 1-14页

作者： Jacobo Trébol Tihomir Georgiev-Hristov Luz Vega-Clemente ignacio garcía-Gómez Ana Carabias-Orgaz Mariano garcía-Arranz Damián garcía-Olmo Department of General and Digestive Tract Surgery University Hospital“La Paz”Madrid 28046Spain Department of General and Digestive Tract Surgery Villalba General HospitalMadrid 28400Spain New Therapies Laboratory Instituto de Investigación Sanitaria-Fundación Jiménez DíazMadrid 28040Spain Hektoen Institute of Medicine ChicagoIL 60612United States Department of Anaesthesiology Complejo Asistencial deávilaávila 05004Spain New Therapies Laboratory Instituto de Investigación Sanitaria-Fundación Jiménez DíazMadrid 28040Spain Department of General and Digestive Tract Surgery Quiron-Salud HospitalsMadrid 28040Spain Department of Surgery Madrid Autonomous UniversityMadrid 28029Spain

AIM To establish a rat model of anal sphincter injury and test different systems to provide stem cells to injured *** Adipose-derived stem cells(ASCs) were isolated from BDIX rats and were transfected with green fluorescent protein(GFP) for cell tracking. Biosutures(sutures covered with ASCs) were prepared with 1.5 × 10~6 GFPASCs, and solutions of 10~6 GFP-ASCs in normal saline were prepared for injection. Anorectal normal anatomy was studied on Wistar and BDIX female rats. Then, we designed an anal sphincter injury model consisting of a 1-cm extra-mucosal miotomy beginning at the anal verge in the anterior middle line. The sphincter lesion was confirmed with conventional histology(hematoxylin and eosin) and immunofluorescence with 4', 6-diamidino-2-phenylindole(commonly known as DAPI), GFP and α-actin. Functional effect was assessed with basal anal manometry, prior to and after injury. After sphincter damage, 36 BDIX rats were randomized to three groups for:(1) Cell injection without repair;(2) biosuture repair; and(3) conventional suture repair and cell injection. Functional and safety studies were conducted on all the animals. Rats were sacrificed after 1, 4 or 7 d. Then, histological and immunofluorescence studies were performed on the surgical *** With the described protocol, biosutures had been covered with at least 820000-860000 ASCs, with 100% viability. Our studies demonstrated that some ASCs remained adhered after suture passage through the muscle. Morphological assessment showed that the rat anal anatomy is comparable with human anatomy; two sphincters are present, but the external sphincter is poorly developed. Anal sphincter pressure data showed spontaneous, consistent, rhythmic anal contractions, taking the form of "plateaus" with multiple twitches(peaks) in each pressure wave. These basal contractions were very heterogeneous; their frequency was 0.91-4.17 per min(mean 1.6980, SD 0.57698), their mean duration was 26.67 s and mean numb

关键词： Fecal incontinence Experimental rat model Anal sphincter Cell implantation Cell therapy Stem cells Mesenchymal stem cell

Science Letters:Visual odometry for road vehicles—feasibility analysis

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Journal of Zhejiang University-Science A(Applied Physics & Engineering) 2007年第12期8卷 2017-2020页

作者： SOTELO Miguel-angel garcíA Roberto PARRA ignacio FERNNDEZ David GAVILN Miguel LVArez Sergio NARANJO José-eugenio Department of Electronics University of Alcalá Alcalá de Henares 28871 Spain Department of Informatics Industrial Automation Institute CSIC Madrid Spain

Estimating the global position of a road vehicle without using GPS is a challenge that many scientists look forward to solving in the near future. Normally, inertial and odometry sensors are used to complement GPS measures in an attempt to provide a means for maintaining vehicle odometry during GPS outage. Nonetheless, recent experiments have demonstrated that computer vision can also be used as a valuable source to provide what can be denoted as visual odometry. For this purpose, vehicle motion can be estimated using a non-linear, photogrametric approach based on RAndom SAmple Consensus (RANSAC). The results prove that the detection and selection of relevant feature points is a crucial factor in the global performance of the visual odometry algorithm. The key issues for further improvement are discussed in this letter.

关键词： 3D visual odometry Ego-motion estimation RAndom SAmple Consensus (RANSAC) Photogrametric approach

Analysis of orthopedic surgical procedures in children with cerebral palsy

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World Journal of Orthopedics 2020年第4期11卷 222-231页

作者： ignacio Rehbein Viviana Teske ignacio Pagano Alejandro Cúneo María Elena Pérez Johan von Heideken Clínica de Traumatología y Ortopedia Pediátrica Facultad de MedicinaUniversidad de la RepúblicaMontevideo 11200Uruguay Department of Women’s and Children’s Health Karolinska InstitutetKarolinska University HospitalStockholm 17177Sweden

BACKGROUND Orthopedic surgery in children with cerebral palsy(CP)aims to improve function and prevent *** child’s condition in CP is unique and many covariables influence surgical decision-making including a patient's age and their functional *** is known about the frequency of different types of orthopedic surgery in children with CP who have varied functional levels,particularly in countries from Latin *** To assess the type of orthopedic surgical procedures in relation to age and gross motor function in children with *** This retrospective study included all children with CP(n=245)treated with elective orthopedic surgery at a Uruguayan university hospital between October 2010 and May 2016 identified from a surgical *** children(7%)were lost to follow-up due to missing medical ***,gross motor function classification(GMFCS),and orthopedic surgeries were obtained from the medical records of 227 ***-squared tests and analysis of variance were used to assess the frequency of surgery,accounting for GMFCS *** age for soft tissue vs bone surgery was compared with the independent samples *** A total of 711 surgical procedures were performed between 1998 and *** average,children had 3.1 surgical procedures and the mean age at first surgery was 8.0 *** were no significant differences in age at first surgery among GMFCS levels(P=0.47).The most common procedures were lower leg soft tissue surgery(n=189,27%),hip tenotomy(n=135,19%),and hamstring tenotomy(n=104,14%).For children with GMFCS level Ⅰ,the mean number of surgeries per child[1.8(range 1-9)]differed significantly at P<0.05 in children with GMFCS levels Ⅱ[3.2(1-12)],Ⅲ[3.2(1-8)],Ⅳ[3.3(1-13)],and Ⅴ[3.6(1-11)].Within Ⅱ,Ⅲ,Ⅳ,and Ⅴ,there was no significant difference in mean number of surgeries per child when comparing across the *** proportion of soft tissue surgery vs bone surgery was higher in GMFCS levels Ⅰ-Ⅲ

关键词： Children Cerebral palsy Gross Motor Function Classification System Surgery Epidemiology