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Cost-effectiveness of endoscopic ultrasound-guided coils plus cyanoacrylate injection compared to endoscopic cyanoacrylate injection in the management of gastric varices

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World Journal of Gastrointestinal Endoscopy 2021年第1期13卷 13-23页

作者： Carlos Robles-Medranda Joao Autran Nebel Miguel Puga-Tejada Roberto Oleas jorge baquerizo-burgos Jesenia Ospina-Arboleda Manuel Valero Hannah Pitanga-Lukashok Gastroenterology and Endoscopy Division Instituto Ecuatoriano de Enfermedades DigestivasGuayaquil 090505GuayasEcuador

BACKGROUND Cyanoacrylate(CYA)injection can be performed using a standard upper endoscopy technique or under endoscopic ultrasound(EUS)guidance alone or in combination with *** is little information available on the economic impact of these treatment *** To compare the cost-effectiveness of treating gastric varices by CYA injection via upper endoscopy vs coils plus CYA guided by *** This was an observational,descriptive,and retrospective *** were allocated into two groups:A CYA group and coils plus CYA *** baseline characteristics were compared,and a cost analysis was *** Overall,36 patients were included(19 in the CYA group and 17 in the coils+CYA group).All patients in the CYA group had acute *** underwent a higher mean number of procedures(1.47 vs 1,P=0.025),and the mean volume of glue used was 2.15 vs 1.65 mL,P=*** coils+CYA group showed a higher technical success rate(100%vs 84.2%),with a complication rate similar to the CYA *** majority of CYA patients required hospitalization,and although the mean total per procedure cost was lower(United States$1350.29 vs United States$2978),the mean total treatment cost was significantly different(United States$11060.89 for CYA vs United States$3007.13 for coils+CYA,P=0.03).CONCLUSION The use of EUS-guided coils plus cyanoacrylate is more cost-effective than cyanoacrylate injection when the total costs are ***,randomized trials are needed to validate the cost-effectiveness of the EUS-guided approach to treat gastric varices.

关键词： Cost-effectiveness Endoscopic ultrasound-guided therapy Gastric varices Gastrointestinal bleeding Hemostasis Therapy

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High-definition optical magnification with digital chromoendoscopy detects gastric mucosal changes in dyspeptic-patients

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World Journal of Gastrointestinal Endoscopy 2020年第1期12卷 23-32页

作者： Carlos Robles-Medranda Manuel Valero Miguel Puga-Tejada Roberto Oleas jorge baquerizo-burgos Miguel Soria-Alcívar Haydee Alvarado-Escobar Hannah Pitanga-Lukashok Gastroenterology and Endoscopy Division Instituto Ecuatoriano de Enfermedades Digestivas(IECED)

BACKGROUND Accurate detection of gastric infection by Helicobacter pylori(***)and premalignant lesions are important for effective provision of treatment,preventing the development of gastric *** enhancement systems with optical magnification improved the identification of mucosal superficial and vascular patterns in patients with *** To evaluate an optical enhancement system with high-definition magnification,for diagnosis of normal gastric mucosa,***-associated gastritis,and gastric *** A cross-sectional,nonrandomized study from November 2015 to April 2016 performed in a single-tertiary academic center from ***-two consecutive patients with functional dyspepsia according to the Rome III criteria,were tested for *** using a stool antigen test and were assigned to an Hp+group or an Hp−control *** with highdefinition optical magnification and digital chromoendoscopy was performed,and patients were classified into 4 groups,in accordance to the microvasculararchitecture pattern of the *** and intraobserver agreement among operators were *** Of the 72 participants,35 were Hp+and 37 were Hp−.Among 10 patients with normal mucosal histology in biopsy samples,90%had a Type I pattern of microvascular architecture by *** participants with type IIa and type IIb patterns,significantly more were Hp+than Hp−(32 vs 8),and most(31 out of 40)had histological diagnoses of chronic active *** of the three participants with a histological diagnosis of atrophy had a type III microvascular *** type I pattern predicted normal mucosa,type IIa–IIb predicted *** infection,and type III predicted atrophy with sensitivities of 90.0%,91.4%,and 66.7%,*** intraobserver and interobserver agreements had kappa values of 0.91 and 0.89,*** High-definition optical magnification with digital chromoendoscopy is useful

关键词： Gastritis Helicobacter pylori Gastric mucosa Atrophic Endoscopy Digestive system

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Endoscopic ultrasound elastography for malignant pancreatic masses and associated lymph nodes:Critical evaluation of strain ratio cutoff value

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World Journal of Gastrointestinal Endoscopy 2022年第9期14卷 524-535页

作者： Miguel Puga-Tejada Raquel Del Valle Roberto Oleas Maria Egas-Izquierdo Martha Arevalo-Mora jorge baquerizo-burgos Jesenia Ospina Miguel Soria-Alcivar Hannah Pitanga-Lukashok Carlos Robles-Medranda Endoscopy Division Instituto Ecuatoriano de Enfermedades DigestivasGuayaquil 090505GuayasEcuador Universidad de Guayaquil Guayaquil 090505GuayasEcuador

BACKGROUND Endoscopic ultrasound(EUS)can detect small lesions throughout the digestive tract;however,it remains challenging to accurately identify malignancies with this *** elastography measures tissue hardness,by which malignant and nonmalignant pancreatic masses(PMs)and lymph nodes(LNs)can be ***,there is currently little information regarding the strain ratio(SR)cutoff in Hispanic *** To determine the diagnostic accuracy of EUS elastography for PMs and LNs with an SR cutoff value in *** A retrospective study of patients who underwent EUS elastography for PMs between December 2013 and December 2014.A qualitative(analysis of color maps)and quantitative(SR)analysis of PMs and their associated LNs was *** accuracy of EUS elastography in identifying malignant PMs and LNs and cutoff value for SR were analyzed.A PM and/or its associated LNs were considered malignant based on histopathological findings from fine-needle aspiration biopsy *** A sample of 121 patients was included,45.4%of whom were female.69(57.0%)PMs were histologically malignant,with a median SR of 50.4 vs 33.0 for malignant vs nonmalignant masses(P21.5 yielded a sensitivity of 94.2%,while a cutoff value of>121 yielded a specificity of 96.2.2%.There were significant differences in the Giovannini scores,a previously established elastic score system,between the patients grouped by their final histology results(P14.0 and>155 yielded a sensitivity of 90.9%and a specificity of 95.2%,respectively,in detecting *** EUS elastography is a helpful technique for the diagnosis of solid PMs and their associated LNs.T

关键词： Ultrasound Elastography Pancreas Lymph nodes Neoplasm

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Endoscopic ultrasound-guided through-the-needle microforceps biopsy and needle-based confocal laser-endomicroscopy increase detection of potentially malignant pancreatic cystic lesions:A single-center study

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World Journal of Gastrointestinal Endoscopy 2022年第3期14卷 129-141页

作者： Carlos Robles-Medranda Juan I Olmos Miguel Puga-Tejada Roberto Oleas jorge baquerizo-burgos Martha Arevalo-Mora Raquel Del Valle Zavala Joao Autran Nebel Daniel Calle Loffredo Hannah Pitanga-Lukashok Gastroenterology and Endoscopy Division Instituto Ecuatoriano de Enfermedades DigestivasGuayaquil 090505Ecuador

BACKGROUND Currently,there is insufficient data about the accuracy in the diagnosing of pancreatic cystic lesions(PCLs),especially with novel endoscopic techniques such as with direct intracystic micro-forceps biopsy(mFB)and needle-based confocal laser-endomicroscopy(nCLE).AIM To compare the accuracy of endoscopic ultrasound(EUS)and associated techniques for the detection of potentially malignant PCLs:EUS-guided fine needle aspiration(EUS-FNA),contrast-enhanced EUS(CE-EUS),EUS-guided fiberoptic probe cystoscopy(cystoscopy),mFB,and *** This was a single-center,retrospective *** identified patients who had undergone EUS,with or without additional diagnostic techniques,and had been diagnosed with *** determined agreement among malignancy after 24-mo follow-up findings with detection of potentially malignant PCLs via the EUSguided techniques and/or EUS-guided biopsy when available(EUS malignancy detection).RESULTS A total of 129 patients were included, with EUS performed alone in 47/129. In 82/129 patients,EUS procedures were performed with additional EUS-FNA (21/82), CE-EUS (20/82), cystoscopy(27/82), mFB (36/82), nCLE (44/82). Agreement between EUS malignancy detection and the 24-mo follow-up findings was higher when associated with additional diagnostic techniques thanEUS alone [62/82 (75.6%) vs 8/47 (17%);OR 4.35, 95%CI: 2.70-7.37;P < 0.001]. The highestmalignancy detection accuracy was reached when nCLE and direct intracystic mFB were bothperformed, with a sensitivity, specificity, positive predictive value, negative predictive value andobserved agreement of 100%, 89.4%, 77.8%, 100% and 92.3%, respectively (P < 0.001 comparedwith EUS-alone).CONCLUSIONThe combined use of EUS-guided mFB and nCLE improves detection of potentially malignantPCLs compared with EUS-alone, EUS-FNA, CE-EUS or cystoscopy.

关键词： Pancreatic cysts Endoscopic ultrasound-guided fine-needle aspiration Confocal microscopy Image-guided biopsy

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Targeting harmful effects of non-excitatory amino acids as an alternative therapeutic strategy to reduce ischemic damage

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Neural Regeneration Research 2025年第9期20卷 2454-2463页

作者： Victoria Jiménez Carretero IrisÁlvarez-Merz jorge Hernández-Campano Sergei A.Kirov Jesús M.Hernández-Guijo Department of Pharmacology and Therapeutic School of MedicineUniv.Autónoma de MadridMadridSpain Ramón y Cajal Institute for Health Research(IRYCIS) Neurobiology-Research ServiceHospital Ramón y CajalMadridSpain Institute of Neurobiology Faculty of Mathematics and Natural SciencesHeinrich Heine University DüsseldorfDüsseldorfGermany Department of Neuroscience and Regenerative Medicine&Department of Neurosurgery Medical College of Georgia at Augusta UniversityAugustaGAUSA

The involvement of the excitatory amino acids glutamate and aspartate in ce rebral ischemia and excitotoxicity is ***,the role of non-excitatory amino acids in brain damage following a stroke or brain trauma remains largely *** release of amino acids by necrotic cells in the ischemic core may contribute to the expansion of the *** findings indicated that the reversible loss of field excitato ry postsynaptic potentials caused by transient hypoxia became irreversible when exposed to a mixture of just four non-excitatory amino acids(L-alanine,glycine,L-glutamine,and L-serine)at their plasma *** amino acids induce swelling in the somas of neurons and astrocytes during hypoxia,along with permanent dendritic damage mediated by N-methyl-D-aspartate *** N-methyl-D-aspartate receptors prevented neuronal damage in the presence of these amino acids during *** is likely that astroglial swelling caused by the accumulation of these amino acids via the alanine-serine-cysteine transporter 2 exchanger and system N transporters activates volume-regulated anion channels,leading to the release of excitotoxins and subsequent neuronal damage through N-methyl-D-aspartate receptor ***,previously unrecognized mechanisms involving non-excitatory amino acids may contribute to the progression and expansion of brain injury in neurological emergencies such as stroke and traumatic brain *** these pathways co uld highlight new therapeutic targets to mitigate brain injury.

关键词： cell swelling N-methyl-D-aspartate receptor non-excitatory amino acids stroke synaptic transmission

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Neuroprotective effects of erythropoietin on neurodegenerative and ischemic brain diseases: the role of erythropoietin receptor

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Neural Regeneration Research 2017年第9期12卷 1381-1389页

作者： Carolina Castillo Hernández Carlos Felipe burgos Angela Hidalgo Gajardo Tiare Silva-Grecchi Javiera Gavilan jorge Roberto Toledo jorge Fuentealba Laboratory of Screening of Neuroactive Compounds Department of Physiology School of Biological Sciences University of Concepción Laboratory of Biotechnology and Biopharmaceutical Department of Pathophysiology School of Biological Sciences University of Concepción

Erythropoietin （Epo） is a fundamental hormone in the regulation of hematopoiesis, and other secondary roles mediated by the binding of the hormone to its specific receptor （EpoR）, which leads to an activation of key signaling pathways that induce an increase in cell differentiation, apoptosis control and neuroprotection. It has been suggested that their ftmction depends on final conformation of glycosylations, related with affinity to the receptor and its half-life. The presence of EpoR has been reported in different tissues including central nervous system, where it has been demonstrated to exert a neuroprotective function against oxidative stress conditions, such as ischemic injury and neurodegenerative diseases. There is also evidence of an increase in EpoR expression in brain cell lysates of Alzheimer＇s patients with respect to healthy patients. These results are related with extensive in vitro experimental data of neuroprotection obtained from cell lines, primary cell cultures and hippocampal slices. Additionally, this data is correlated with in vivo experiments （water maze test） in mouse models of Alzheimer＇s disease where Epo treatment improved cognitive function. These stud- ies support the idea that receptor activation induces a neuroprotective effect in neurodegenerative disorders including dementias, and especially Alzheimer＇s disease. Taken together, available evidence suggests that Epo appears to be a central element for EpoR activation and neuroprotective properties in the central nervous system. In this review, we will describe the mechanisms associated with neuroprotection and its relation with the activation of EpoR in order with identify new targets to develop pharmacological strategies.

关键词： erythropoietin erythropoietin receptor neuroprotection anti-apoptosis Alzheimer's disease

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The sexually dimorphic expression of glutamate transporters and their implication in pain after spinal cord injury

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Neural Regeneration Research 2025年第11期20卷 3317-3329页

作者： Jennifer M.Colón-Mercado Aranza I.Torrado-Tapias Iris K.Salgado Jose M.Santiago Samuel E.Ocasio Rivera Dina P.Bracho-Rincon Luis H.Pagan Rivera jorge D.Miranda Department of Physiology University of Puerto RicoMedical Sciences CampusSan JuanPRUSA National Institutes of Health National Human Genome Research InstituteBethesdaMDUSA Universidad Central del Caribe School of MedicineBayamónPRUSA University of Puerto Rico Carolina CampusCarolinaPRUSA Institute of Neurobiology San JuanPRUSA

In addition to the loss of motor function,~60% of patients develop pain after spinal cord *** cellular-molecular mechanisms are not well understood,but the data suggests that plasticity within the rostral,epicenter,and caudal penumbra of the injury site initiates a cellularmolecular interplay that acts as a rewiring mechanism leading to central neuropathic *** can lead to the formation of new connections triggering abnormal sensory *** excitatory glutamate transporters are responsible for the reuptake of extracellular glutamate which makes them a critical target to prevent neuronal hyperexcitability and *** previous studies showed a sexually dimorphic therapeutic window for spinal cord injury after treatment with the selective estrogen receptor modulator *** this study,we investigated the anti-allodynic effects of tamoxifen in male and female rats with spinal cord *** hypothesized that tamoxifen exerts anti-allodynic effects by increasing the expression of glutamate transporters,leading to reduced hyperexcitability of the secondary neuron or by decreasing aberrant *** and female rats received a moderate contusion to the thoracic spinal cord followed by subcutaneous slow-release treatment of tamoxifen or matrix pellets as a control(placebo).We used von Frey monofilaments and the“up-down method”to evaluate mechanical *** treatment decreased allodynia only in female rats with spinal cord injury revealing a sexdependent *** expression profile of glutamatergic transporters(excitatory amino acid transporter 1/glutamate aspartate transporter and excitatory amino acid transporter 2/glutamate transporter-1)revealed a sexual dimorphism in the rostral,epicenter,and caudal areas of the spinal cord with a pattern of expression primarily on *** rodents showed a significantly higher level of excitatory amino acid transporter-1 expression while male rodents showed increased

关键词： allodynia central neuropathic pain EAAT-1/GLAST EAAT-2/GLT-1 glutamate transporters selective estrogen receptor modulator sexual dimorphism spinal cord injury trauma

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Biodiesel production from waste frying oil in sub- and supercritical methanol on a zeolite Y solid acid catalyst

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Frontiers of Chemical Science and Engineering 2013年第4期7卷 401-407页

作者： jorge MEDINA-VALTIERRA jorge RAMIREZ-ORTIZ Department of Chemical & Biochemical Engineering Aguascalientes Institute of Technology Aguascalientes Ags. 20256 M6xico Academic Unit of Chemical Sciences Autonomous University of Zacatecas Zac. 98160 Mexico

Waste frying oil （WFO） is a very important feedstock for obtaining biodiesel at low cost and using WFO in transesterification reactions to produce biodiesel helps eliminate local environmental problems. In this study biodiesel was produced from WFO in sub- and super- critical methanol on a zeolite Y solid acid catalyst. The procedure was optimized using a design of experiments by varying the methanol to WFO molar ratio, the reaction temperature, and the amount of catalyst. Typical biodiesel yields varied from 83 to nearly 100% with methyl esters content ranging from 1.41-1.66mol.L-~ and typical dynamic viscosities of 22.1-8.2 cE Gas chromatography was used to determine the molecular composition of the biodiesel. The reaction products contained over 82 wt-% methyl esters, 4.2 wt-% free acids, 13.5 wt-% monoglycer- ides, and 0.3 wt-% diglycerides. The transesterification of WFO with methanol around its critical temperature combined with a zeolite Y as an acid catalyst is an efficient approach for the production of biodiesel with acceptable yields.

关键词： biodiesel methanol critical temperature,waste frying oil zeolite Y

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Experience with the surgical treatment of hepatic hydatidosis: Case series with follow-up

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World Journal of Gastroenterology 2010年第26期16卷 3305-3309页

作者： Hector Losada Morales Luis burgos San Juan jorge Silva Abarca Cesar Muoz Castro Department of Surgery Universidad de La Frontera Hepato Pancreatic and Biliary Surgery Hospital Hernán Henríquez Aravena Department of Surgery Clínica Alemana de Temuco

AIM: To describe patient characteristics and the results of surgical treatment for hepatic hydatidosis (HH) in the Hospital Hernán Henríquez Aravena from December 2001 to March 2005. METHODS: Subjects older than 16 years with suspected HH were included based on the clinical picture and radiological studies. Variables examined included clinical and laboratory aspects, outcome, features of the parasite and surgical aspects. Descriptive statistics were used, calculating central tendency, dispersion and extreme tendency. RESULTS: The series was comprised of 122 patients, with an average age of 44 ± 16.9 years. The most frequently used surgical technique was subtotal cys-tectomy in 90% of the patients, followed by hepatic resection (hepatectomy, segmentectomy and subsegmentectomy) in 5%. In 2%, a combination of subtotal cystectomy and segmentectomy was performed. In addition, 28% of the series presented complications in the postoperative period and mortality was 2%. CONCLUSION: The most frequently used surgical technique for HH was subtotal cystectomy and the morbidity and mortality rates in this Chilean series are comparable to other national and international series.

关键词： Echinococcosis of liver Surgery Cases series Mortality Morbidity

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Core promoter: A critical region where the hepatitis B virus makes decisions

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World Journal of Gastroenterology 2014年第2期20卷 425-435页

作者： jorge Quarleri Instituto de Investigaciones Biomédicas en Retrovirus y Sida Universidad de Buenos AiresBuenos Aires C1121ABGArgentina

The core promoter(CP) of the viral genome plays an important role for hepatitis B virus(HBV) replication as it directs initiation of transcription for the synthesis of both the precore and pregenomic(pg) RNAs. The CP consists of the upper regulatory region and the basa core promoter(BCP). The CP overlaps with the 3'-end of the X open reading frames and the 5'-end of the precore region,and contains cis-acting elements that can independently direct transcription of the precore mRNA and pgRNA. Its transcription regulation is under strict control of viral and cellular factors. Even though this regulatory region exhibits high sequence conservation,when variations appear,they may contribute to the persistence of HBV within the host,leading to chronic infection and cirrhosis,and eventually,hepatocellular carcinoma. Among CP sequence variations,those occurring at BCP may dysregulate viral gene expression with emphasis in the hepatitis B e antigen,and contribute to disease progression. In this review these molecular aspects and pathologic topics of core promoter are deeply evaluated.

关键词： Hepatitis B virus Core promoter Variants Basal core promoter Transcription regulation

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