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New therapeutic strategy with extracorporeal membrane oxygenation for refractory hepatopulmonary syndrome after liver transplant: A case report

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World Journal of Transplantation 2024年第1期14卷 210-214页

作者： Belinda Sánchez Pérez María Pérez Reyes jose Aranda Narvaez Julio Santoyo Villalba jose antonio perez daga Claudia Sanchez-Gonzalez Julio Santoyo-Santoyo Hepatobiliary and Trasplantation Unit General and Digestive Surgery DepartmentUniversity Regional HospitalMalaga 29010Spain Department of General and Digestive Surgery Regional University Hospital of MalagaMalaga 29010Spain

BACKGROUND Due to the lack of published literature about treatment of refractory hepatopulmonary syndrome(HPS)after liver transplant(LT),this case adds information and experience on this issue along with a treatment with positive *** is a complication of end-stage liver disease,with a 10%-30%incidence in cirrhotic *** can reverse the physiopathology of this process and restore normal ***,in some cases,refractory hypoxemia persists,and extracorporeal membrane oxygenation(ECMO)can be used as a rescue therapy with good *** SUMMARY A 59-year-old patient with alcohol-related liver cirrhosis and portal hypertension was included in the LT waiting list for *** had good liver function(Model for End-Stage Liver Disease score 12,Child-Pugh class B7).He had pulmonary fibrosis and a mild restrictive respiratory pattern with a basal oxygen saturation of 82%.The macroaggregated albumin test result was>*** demonstrated a forced expiratory volume in one second(FEV1)of 78%,forced vital capacity(FVC)of 74%,FEV1/FVC ratio of 81%,diffusion capacity for carbon monoxide of 42%,and carbon monoxide transfer coefficient of 57%.He required domiciliary oxygen at 2 L/min(16 h/d).The patient was admitted to the intensive care unit(ICU)and extubated in the first 24 h,needing high-flow therapy and non-invasive ventilation and inhaled nitric oxide *** was needed after 72 *** to the non-response to supportive therapies,installation of ECMO was decided with progressive recovery after 9 *** was possible on the tenth day,maintaining a high-flow nasal cannula and de-escalating to conventional oxygen therapy after 48 *** was discharged from ICU on postoperative day(POD)20 with a 90%-92%oxygen *** recycling was needed twice for acute *** patient was discharged from hospital on POD 27 with no symptoms,with an 89%-90%oxygen *** Due to the favorable results observed,ECMO could bec

关键词： Liver transplantation Hepatopulmonary syndrome Refractory hypoxemia Treatment Extracorporeal membrane oxygenation Case report

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Immediate post-operative complications(I):Post-operative bleeding;vascular origin:Thrombosis pancreatitis

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World Journal of Transplantation 2020年第12期10卷 415-421页

作者： jose antonio perez daga Rosa perez Rodriguez Julio Santoyo Department of Surgery Hospital Regional de MálagaMalaga 29010Spain

Simultaneous pancreas-kidney transplantation is the treatment of choice forinsulin-dependent diabetes that associates end-stage diabetic nephropathy, sinceit achieves not only a clear improvement in the quality of life, but also provides along-term survival advantage over isolated kidney transplant. However, pancreastransplantation still has the highest rate of surgical complications among organtransplants. More than 70% of early graft losses are attributed to technical failures,that is, to a non-immunological cause. The so-called technical failures includegraft thrombosis, bleeding, infection, pancreatitis, anastomotic leak and pancreaticfistula. Pancreatic graft thrombosis leads these technical complications as the mostfrequent cause of early graft loss. Currently most recipients receive postoperativeanticoagulation with the aim of reducing the rate of thrombosis. Hemoperitoneumin the early postoperative period is a frequent cause of relaparotomy, but it is notusually associated with graft loss. The incidence of hemoperitoneum is clearlyrelated to the use of anticoagulation in the postoperative period. Post-transplantpancreatitis is another cause of early postoperative complications, less frequentthan the previous. In this review, we analyze the most common surgicalcomplications that determine pancreatic graft losses.

关键词： Pancreas transplantation Vascular graft thrombosis Postoperative hemorrhage Graft pancreatitis Reperfusion injury Tissue donors Risk factors

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Risk factors and classifications of hilar cholangiocarcinoma

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World Journal of Gastrointestinal Oncology 2013年第7期5卷 132-138页

作者： Miguel Angel Suarez-Munoz jose Luis Fernandez-Aguilar Belinda Sanchez-perez jose antonio perez-daga Beatriz Garcia-Albiach Ysabel Pulido-Roa Naiara Marin-Camero Julio Santoyo-Santoyo General Digestive and Transplantation Surgery Service HPB and Liver Transplant UnitUniversity Hospital Carlos Haya29010 MalagaSpain

Cholangiocarcinoma is the second most common primary malignant tumor of the *** cholangiocarcinoma or Klatskin tumor represents more than 50% of all biliary tract cholangiocarcinomas.A wide range of risk factors have been identified among patients with Perihilar cholangiocarcinoma including advanced age,male gender,primary sclerosing cholangitis,choledochal cysts,cholelithiasis,cholecystitis,parasitic infection(Opisthorchis viverrini and Clonorchis sinensis),inflammatory bowel disease,alcoholic cirrhosis,nonalcoholic cirrhosis,chronic pancreatitis and metabolic *** classifications have been used to describe the pathologic and radiologic appearance of *** three systems most commonly used to evaluate Perihilar cholangiocarcinoma are the Bismuth-Corlette(BC) system,the Memorial Sloan-Kettering Cancer Center and the TNM *** BC classification provides preoperative assessment of local *** Memorial Sloan-Kettering cancer center proposes a staging system according to three factors related to local tumor extent:the location and extent of bile duct involvement,the presence or absence of portal venous invasion,and the presence or absence of hepatic lobar *** TNM classification,besides the usual descriptors,tumor,node and metastases,provides additional information concerning the possibility for the residual tumor(R) and the histological grade(G).Recently,in 2011,a new consensus classification for the Perihilar cholangiocarcinoma had been *** consensus was organised by the European Hepato-PancreatoBiliary Association which identified the need for a new staging system for this type of *** classification includes information concerning biliary or vascular(portal or arterial) involvement,lymph node status or metastases,but also other essential aspects related to the surgical risk,such as remnant hepatic volume or the possibility of underlying disease.

关键词： Hilar cholangiocarcinoma Klatskin tumor Perihilar cholangiocarcinoma Bile duct cancer

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Impact of socioeconomic and health-related factors on consumption of homeopathic and natural remedies in Spain in 2006, 2011 and 2017

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Journal of Integrative Medicine 2022年第1期20卷 52-56页

作者： jose antonio Castilla-Jimena Isabel Ruiz-perez Jesus Henares-Montiel Andalusian School of Public Health 1801J GranadaSpain Unit of Clinical Management of Preventive Medicine and Public Health and Occupational Medicine Puerto del Mar University Hospital11009 CadizSpain Consortium for Networked Biomedical Research in Epidemiology and Public Health 28029 MadridSpain Institute for Biosanitary Research(ibs.GRANADA) 18012 GranadaSpain

Objective: Complementary and alternative medicine use and type of use may be influenced by sociodemographic and economic determinants through which we could identify characteristics of patients with greater trend to use it. This paper aims to describe the changes in the consumption of homeopathic and natural remedies in Spain for three time points in order to discern changes in rate of consumption, associated factors and whether their use has been affected by a period of economic ***: This study utilized 2006, 2011 and 2017 cross-sectional data from the Spanish National Health Survey, a nationally representative survey of the population aged more than 15 years old and resident in Spain. Independent bivariate and multivariate descriptive analyses for each of the 3 years studied were ***: The rate of consumption of both homeopathic and natural remedies has decreased over the periods studied. In spite of this decrease, the consumer profile appears to remain stable over the three periods. The sociodemographic factors associated with their consumption were being female, being 30–64 years old, being separated/divorced, having higher education qualifications, being employed and belonging to a higher social class. Psychiatric morbidity, chronic health problems such as pain, mental health problems or malignant tumors, and absence of major cardiovascular events were the clinical factors ***: It can be concluded that beyond the economic situation, the use of homeopathic and natural remedies obeys to the needs of the patients related to their state of health and the response they receive from the health system. It may be that women have different needs and expectations of the healthcare system and, given this breach of expectations, seek remedy to alleviate their needs outside the system and conventional medicine.

关键词： Complementary and alternative medicine Homeopathic remedies Natural remedies Economic recession Gender differences

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HVEM,a cosignaling molecular switch,and its interactions with BTLA,CD160 and LIGHT

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Cellular & Molecular Immunology 2019年第7期16卷 679-682页

作者： jose Ignacio Rodriguez-Barbosa Pascal Schneider Andreas Weigert Kyung-Mi Lee Tae-Jin Kim jose-antonio perez-Simon Maria-Luisa del Rio Transplantation Immunobiology Section Research Institutes of the University of LeonCampus of Vegazana s/n24071 LeonSpain Leon Regional Transplantation Coordination Center Leon University HospitalLeonSpain Acción Estratégica en Salud Consorcio CIBER-ONCSevilleSpain Department of Biochemistry University of Lausanne1066 EpalingesSwitzerland Institute of Biochemistry I Faculty of MedicineGoethe-University Frankfurt60590 FrankfurtGermany Department of Biochemistry and Molecular Biology Korea University College of MedicineSeoul 02841Republic of Korea Department of Biomedical Engineering Center for Bio-Integrated ElectronicsSimpson Querrey Institute for BioNanotechnologyNorthwestern UniversityEvanstonIL 60208USA Department of Hematology Virgen del Rocio University HospitalBiomedical Institute of SevillaSevillaSpain

Temporal and spatial expression of cosignaling receptors and their ligands regulates the early stages of T-cell activation(signal 1,T-cell receptor(TCR)signaling and signal 2,costimulation/coinhibition),clonal expansion and T-cell survival during their differentiation towards effector T *** the inflammatory stimulus is eliminated,effector T cells return to homeostasis after undergoing a contraction phase by activation-induced cell death and the intervention of ligands for coinhibitory receptors,leaving a population of long-term memory T *** expression of ligands for coinhibitory receptors on hematopoietic cells and,more importantly,on non-hematopoietic cells of peripheral tissues is a key process in tuning the functional activity of effector T cells to prevent excess tissue inflammation that may lead to immunopathology and subsequent tissue dysfunction.

关键词： stimulation homeostasis inflammation

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Use of subcutaneous tocilizumab to prepare intravenous solutions for COVID-19 emergency shortage:Comparative analytical study of physicochemical quality attributes

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Journal of Pharmaceutical Analysis 2020年第6期10卷 532-545页

作者： Natalia Navas Jesús Hermosilla Anabel Torrente-Lopez jose Hernandez-Jimenez jose Cabeza Raquel perez-Roblesa antonio Salmeron-García Department of Analytical Chemistry Science Faculty/Biomedical Research Institute ibs.GranadaUniversity of GranadaGranadaE-18071Spain UGC Farmacia Hospitalaria Biomedical Research Institute ibs.Granada.Hospital Universitario San Cecilio de GranadaGranadaE-18012Spain

COVID-19,a disease caused by the novel coronavirus SARS-Co V-2,has produced a serious emergency for global public health,placing enormous stress on national health systems in many *** studies suggest that cytokine storms(interleukins)may play an important role in severe cases of *** key inflammatory factors in cytokine release syndrome(CRS)could therefore be of great value in reducing the mortality ***(TCZ)in its intravenous(IV)form of administration-Ro Actemra?20 mg/m L(Roche)-is indicated for treatment of severe CRS *** investigations have concluded that inhibition of IL-6 with TCZ appears to be efficacious and safe,with several ongoing clinical *** has led to a huge increase in demand for IV TCZ for treating severe COVID-19 patients in hospitals,which has resulted in drug ***,we present a comparability study assessing the main critical physicochemical attributes of TCZ solutions used for infusion,at 6 mg/m L and 4 mg/m L,prepared from Ro Actemra?20 mg/m L(IV form)and from Ro Actemra?162 mg(0.9 m L solution pre-filled syringe,subcutaneous(SC)form),to evaluate the use of the latter for preparing clinical solutions required for IV administration,so that in a situation of shortage of the IV medicine,the SC form could be used to prepare the solutions for IV delivery of *** is important to remember that during the current pandemic all the medicines are used off-label,since none of them has yet been approved for the treatment of COVID-19.

关键词： COVID-19 Tocilizumab Critical quality attributes IV and SC medicines

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High-resolution patterns of palaeoenvironmental changes during the Little Ice Age and the Medieval Climate Anomaly in the northwestern Iberian Peninsula

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Geoscience Frontiers 2020年第5期11卷 1461-1475页

作者： Daniel Castro Martin Souto Maria Isabel Fraga Eduardo Garcia-Rodeja Sebastian perez-Diaz jose antonio Lopez Saez Xabier Pontevedra-Pombal Dpto.Botanica Fac.BioloxiaUniversidade de Santiago de CompostelaGaliciaSpain Dpto.Edafoloxia e Quimica Agricola Fac.BioloxiaUniversidade de Santiago de CompostelaGaliciaSpain Dpto.Geografia Urbanismo y Ordenacion Del TerritorioETS CaminosCanales y PuertosUniversidad de CantabriaSpain GI Arqueobiologia Instituto de HistoriaCCHS–CSICMadridSpain

to identify plant macrofossils,estimate peat humification and calculate hydroclimatic indices based on current bog species,with the overall aim of determining the climate conditions associated with evolution of the bog during the Medieval Climate Anomaly and the Little Ice *** proxies,together with historical and climate data,proved to be good indicators of the changes in bog surface ***:of the core led to identification of 9 different periods:two corresponding to the so-called Medieval Climate Anomaly(930 to 1345 AD,1075–665 calibrated years before present[*** BP]);four corresponding to the Little Ice Age(1345 to 1905 AD;665–105 cal yr BP);and three corresponding to the last century(1905 to 2000 AD).The findings revealed a generally dry climate that lasted until the 14th century,followed by a transition to a long period with a more humid,but characteristically very variable climate,which ended at the beginning of the 20th century and was followed by a rapid transition to more humid conditions and finally,a change to drier *** Medieval Climate Anomaly was indicated by the abundance of dry-adapted mosses(Leucobryum glaucum,Hypnum cupressiforme)and characterized by warm dry conditions and high levels of peat humification,with alternating wet *** LIA period was dated by a large abundance of Sphagnum species(an indicator of wetness)and a gradual increase in the humification ***,four different climate phases were differentiated in this ***-resolution reconstruction of the evolution of the CVM bog and the multiproxy approach have together enabled a more detailed identification of climatic variations in this area,which are generally consistent with the global models,as well as better definition of the elusive climatic oscillations in the last millennium and confirmation of the importance of local modulation of global *** study provides new information and a detailed chronology of climatic events that will hel

关键词： Last millennium Raised bog Plant macrofossil Humification analysis Southwest Europe Climate change

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Controlled building of CdSe@ZnS/Au and CdSe@ZnS/ Au2S/Au nanohybrids

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Nano Research 2015年第7期8卷 2271-2287页

作者： Raquel E. Galian Pilar Diaz antonio Ribera Alejandro Rincon-Bertolin Said Agouram Julia perez-Prieto Instituto de Ciencia Molecular (ICMol) Universidad de Valencia c/ Catedrdtico Jose Beltran 2 46980 Paterna Valencia Spain Department of Applied Physics and Electromagnetism Dr. Moliner 50 Universidad de Valencia 461 00 Burjassot Valencia Spain

The addition of Au3. to spherical amine-capped CdSe@ZnS nanoparticles in toluene at room temperature and under darkness can lead to ternary CdSe@ZnS/Au nanohybrids. We demonstrate that this happens only when the nanoparticles possess a relatively thin ZnS shell, thus showing that thickness plays a key role in gold deposition on the CdSe@ZnS nanoparticle surface. Our hypothesis is that the amine ligand acts as the reductant of Au3＋ ions into Au＋ ions, whose affinity for sulfur would keep them at the CdSe@ZnS surface. This interaction stabilizes the Au＋ ion, making it less prone to reduction than a non-coordinated Au＋ ion. In CdSe@ZnS with a thin shell, Au＋ ions at the surface of, or most probably within, the ZnS shell cause the transfer of Cd2＋ ions into the solution. Subsequently, the core Se2- anion, which is a better reductant than the shell S2- reduces Au＋ ions to Au（0）, and large gold nanoparticles （AuNPs） are quickly deposited on the CdSe@ZnS surface in room temperature process, leading to ternary CdSe@ZnS/Au nanohybrids. In solution, these ternary nanohybrids progressively transform into quaternary CdSe@ZnS/Au2S/Au nanohybrids due to the reaction of the shell S2- anion with the remaining Au＋ at the CdSe@ZnS surface, thus leading to the growth of Au2S nanoparticles on the CdSe@ZnS surface while Zn concomitantly leaches from the nanohybrid into the solution. Photoirradiation of the heterostructures with visible light enhances their emission efficiency. Comparatively, irradiation of the precursors, i.e., CdSe@ZnS nanoparticles, causes a drastic decrease in their emission accompanied by a blue shift of their emission maximum. The optical properties of these nanohybrids were analyzed by absorption and fluorescence （steady-state and time-resolved） spectroscopy, and the composition of the samples and the chemical states were determined by energy dispersive X-ray spectroscopy （EDX） and X-ray photoelectron spectroscopy （XPS）, respectively. Finally, the structural and m

关键词： heterostructures semiconductor nanoparticle metallic fluorescence time-resolved studies

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Education and Employment （2005-2009） A Comparative Analysis Between the Spanish and Foreign Working Population

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Chinese Business Review 2012年第4期11卷 411-423页

作者： Ma Olga Gonzalez Morales Flora Ma Diaz perez jose antonio Alvarez Gonzalez University of La Laguna S/C Tenerife Spain

Spain became a net receiver country of a high number of foreigners entering the labour market in the first decade of the 21 st century. The ensuing economic crisis, beginning in 2007, led to the destruction of a large number of companies and jobs. The objective of this paper is to analyze the relationship between educational level, employment and economic activity, in the Spanish and foreign working population in the Spanish labour market and the impact that the economic crisis is having on employment and self-employment. The hypotheses considered have been as followed--HI： The economic crisis mainly affects the less educated working population, both Spanish and foreign; H2： Self-employment is characterized by being an initiative of a working population with low educational levels for both population groups （Spanish and foreign）; H3： Employment is related to the productive economic structure. Micro-data from the Labour Force Survey 2009 （EPA in Spanish） has been used, compiled by Spains National Statistics Office （INE in Spanish）, and it has been applied Multiple Correspondence Analysis （MCA） to detect possible associations among the study variables （nationality, level of education, salaried employment, self-employment and economic activity）. The results show significant differences between both groups： Spanish and foreign working population. The study also shows how the crisis affects employment, and the important role played by the educational level of the working population, especially foreigners employed in certain economic activities.

关键词： working population nationality salaried employment self-employed level of education activity sector economic crisis

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Emergency Atypical Resection for Perforated Gastric Gist

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Open Journal of Gastroenterology 2014年第3期4卷 118-120页

作者： Manuel Muinelo Lorenzo Lucia Dorado Castro Maria Isabel perez Moreiras jose Conde Vales jose antonio Costa Buján Department of General Surgery and Digestive Diseases Lucus Augusti Universitary Hospital Lugo Spain

We report the case of a 77-year-old male who came to the emergency department with epigastric pain accompanied by fever and chills. After the diagnosis of intra-abdominal abscess and gastric tumor, emergency surgery w... 详细信息

关键词： GIST Gastrectomy Intra-Abdominal Abscess

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