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Impact of payment source, referral site, and place of residence on outcomes after allogeneic transplantation in Mexico

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World Journal of Transplantation 2024年第2期14卷 76-87页

作者： Andrés Gómez-De León Yesica A López-Mora Valeria García-Zárate Ana Varela-Constantino Sergio U Villegas-De Leon Xitlaly J González-Leal Raúl del Toro-Mijares Anna C Rodríguez-Zúñiga juan F Barrios-Ruiz Victor Mingura-Ledezma Perla R Colunga-Pedraza Olga G Cantú-Rodríguez César H Gutiérrez-Aguirre Luz Tarín-Arzaga Elías E González-López David Gómez-Almaguer Hematology Service Universidad Autónoma de Nuevo LeónFacultad de Medicina y Hospital Universitario Dr.JoséEleuterio GonzálezMonterrey 64460Nuevo LeónMexico Hemato-logy Service Clínica Gómez AlmaguerMonterrey 64710Nuevo LeónMexico Hematology Service Instituto Tecnológico de Estudios Superiores de MonterreyTec SaludEscuela de Medicina Ignacio SantosMonterrey 64710Nuevo LeónMexico

BACKGROUND The impact of social determinants of health in allogeneic transplant recipients in low-and middle-income countries is poorly *** observational study analyzes the impact of place of residence,referring institution,and transplant cost coverage(out-of-pocket vs government-funded vs private insurance)on outcomes after allogeneic hematopoietic stem cell transplantation(alloHSCT)in two of Mexico's largest public and private *** To evaluate the impact of social determinants of health and their relationship with outcomes among allogeneic transplant recipients in *** In this retrospective cohort study,we included adolescents and adults≥16 years who received a matched sibling or haploidentical transplant from *** were selected without regard to their diagnosis and were sourced from both a private clinic and a public University Hospital in *** payment groups were compared:Out-of-pocket(OOP),private insurance,and a federal Universal healthcare program“Seguro Popular”.Outcomes were compared between referred and institution-diagnosed patients,and between residents of Nuevo Leon and *** outcomes included overall survival(OS),categorized by residence,referral,and payment *** outcomes encompassed early mortality,event-free-survival,graft-versus-host-relapse-free survival,and non-relapse-mortality(NRM).Statistical analyses employed appropriate tests,Kaplan-Meier method,and Cox proportional hazard regression *** software included SPSS and R with tidycmprsk *** Our primary outcome was overall *** included 287 patients,n=164 who lived out of state(57.1%),and n=129 referred from another institution(44.9%).The most frequent payment source was OOP(n=139,48.4%),followed by private insurance(n=75,26.1%)and universal coverage(n=73,25.4%).No differences in OS,event-free-survival,NRM,or graft-versus-host-relapse-free survival were observed for patients dia

关键词： Hematopoietic cell transplant Social determinants of health Geography Haploidentical Out-of-pocket Financial toxicity Survival Health services and outcomes Hematopoietic malignancy Aplastic anemia

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Transcatheter aortic valve implantation in very elderly patients： immediate results and medium term follow-up

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Journal of Geriatric Cardiology 2015年第4期12卷 340-345页

作者： Isaac Pascual Antonio J Mu oz-García Diego López-Otero Pablo Avanzas Manuel F Jimenez-Navarro Belén Cid-Alvarez Raquel del Valle juan H Alonso-Briales Raimundo Ocaranza-Sanchez josé M Hemández Ramiro Trillo-Nouche César Morís Area del Corazón Hospital Universitario Central de Asturias Av. Roma Oviedo Asturias Spain Department of Cardiology Hospital Universitario Virgen de la Victoria Campus de Teatinos Málaga Spain Department of Cardiology Complejo Hospitalario Universitario de Santiago de Compostela Travesla da Choupana A Coru a Spain

Objective To evaluate immediate transcatheter aortic valve implantation （TAVI） results and medium-term follow-up in very elderly pa- tients with severe and symptomatic aortic stenosis （AS）. Methods This multicenter, observational and prospective study was carried out in three hospitals. We included consecutive very elderly （〉 85 years） patients with severe AS treated by TAVI. The primary endpoint was to evaluate death rotes from any cause at two years. Results The study included 160 consecutive patients with a mean age of 87 ± 2.1 years （range from 85 to 94 years） and a mean logistic EuroSCORE of 18.8% ± 11.2% with 57 （35.6%） patients scoring 〉 20%. Procedural success rate was 97.5%, with 25 （15.6%） patients experiencing acute complications with major bleeding （the most frequent）. Global mortality rate during hospitalization was 8.8% （n = 14） and 30-day mortality rate was 10% （n = 16）. Median follow up period was 252.24± 232.17 days. During the follow-up period, 28 （17.5%） patients died （17 of them due to cardiac causes）. The estimated two year overall and cardiac survival rates using the Kaplan-Meier method were 71% and 86.4%, respectively. Cox proportional hazard regression showed that the variable EuroSCORE ≥ 20 was the unique vari- able associated with overall mortality. Conclusions TAVI is safe and effective in a selected population of very elderly patients. Our findings support the adoption of this new procedure in this complex group of patients.

关键词： Aortic stenosis High surgical risk Transcatheter aortic valve Very elderly patients

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Extensive pollen immigration and no evidence of disrupted mating patterns or reproduction in a highly fragmented holm oak stand

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Journal of Plant Ecology 2014年第4期7卷 384-395页

作者： Joaquín Ortego Raúl Bonal Alberto Muñoz joséMiguel Aparicio Grupo de Investigación de la Biodiversidad Genética y Cultural Instituto de Investigación en Recursos Cinegéticos-IREC(CSICUCLMJCCM)Ronda de Toledo s/nE-13005 Ciudad RealSpain Departamento de Ecología Evolutiva Museo Nacional de Ciencias Naturales(CSIC)C/JoséGutiérrez Abascal 2E-28006 MadridSpain Departamento de Didáctica de las Ciencias Experimentales Facultad de EducaciónUniversidad Complutense de MadridC/Rector Royo Villanova s/nE-28040 MadridSpain Centre de Recerca Ecològica i Aplicacions Forestals(CREAF) Cerdanyola del VallèsE-08193 BarcelonaSpain

Aims Forest fragmentation and reduced tree population densities can poten-tially have negative impacts on mating patterns,offspring genetic diversity and reproductive *** aim of the present study is to test these hypotheses comparing an extremely fragmented,low tree density(~0.02 trees/ha)holm oak(Quercus ilex l.)stand from Central spain with a nearby high tree density stand(~50 trees/ha).Methods We genotyped adult trees and seeds from the low-density stand(436 seeds from 15 families)and the high-density stand(404 seeds from 11 families)using nine microsatellite *** these data,we performed paternity analyses,determined pollen flow,mating patterns and pollen pool structure,and estimated progeny genetic diversity in both *** also studied seed set and production and performed a pollen supplementation experiment to determine whether reduced tree density has limited foreign pollen *** Findings We have found extensive pollen immigration(>75%)into the low tree density stand and monte Carlo simulations revealed that pollen moves larger distances than expected from null models of random *** patterns and differentiation of pollen pools were similar in the high-density stand and the low-density stand but we found higher inter-annual differentiation of pollen pools in the *** genetic diversity and self-fertilization rates did not dif-fer between the low-density stand and the high-density *** set rates were significantly lower in the low-density stand than in the high-density stand and experimental cross-pollen supplementation evidenced that foreign pollen availability is indeed a limiting factor in the ***,seed crops did not differ between the low-density stand and the high-density stand,indicating that limitation of foreign pollen is not likely to be of great concern in terms of reduced seed production and potential *** forest regeneration due to other ecological and human fac

关键词： forest fragmentation genetic diversity paternity analyses pollen dispersal pollen pool structure selfing tree density

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Ligation or Occlusion of the Internal Iliac Arteries for the Treatment of Placenta Accreta Spectrum:Why Is This Technique Still Performed?

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Maternal-Fetal Medicine 2023年第3期5卷 131-136页

作者： Albaro josé Nieto-Calvache josé M.Palacios-Jaraquemada Rozi Aditya Aryananda Nicolas Basanta juan Manuel Burgos-Luna Fernando Rodriguez Carlos Ordonez Daniela Sarria-Ortiz Laura Munoz-Cordoba juan Carlos Quintero Valentina Galindo-Velasco Adriana Messa-Bryon Fundación Valle del Lili Departamento de Ginecología y ObstetriciaClínica de Espectro de Acretismo PlacentarioCali 760032Colombia Latin American Group for the Study of Placenta Accreta Spectrum Departamento de Ginecología y Obstetricia Hospital Universitario CEMICBuenos Aires C1431FWOArgentina Department of Obstetrics and Gynecology Dr.Soetomo Academic General HospitalUniversitas AirlanggaSurabaya 60131Indonesia Departamento de Ginecología y Obstetricia Hospital General de Agudos Juan A FernándezBuenos Aires 7011Argentina Fundación Valle del Lili Centro de Investigaciones ClínicasCali 760032Colombia Unidad de diagnóstico prenatal Clínica ImbanacoGrupo Quirón SaludCali 760042Colombia Departamento de ginecología y obstetricia Universidad del ValleCali 760042Colombia Universidad Icesi Facultad de Ciencias de la SaludCali 760031Colombia

Introduction The major complication of placenta accreta spectrum(PAS)disorder is massive bleeding;therefore,multiple vascular interventions have been described to prevent or treat pelvic *** of the internal iliac arteries(IIAs)was published more than 130 years ago,and although research relating to the physiology of this procedure has demonstrated poor vascular control over the last few decades,2-this technique has evolved into an established technique known as endovascular IIA balloon occlusion.

关键词： balloon Internal bleeding

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Influence of occult hepatitis B virus infection in chronic hepatitis C outcomes

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World Journal of Gastroenterology 2011年第12期17卷 1558-1562页

作者： Conrado M Fernandez-Rodriguez Maria Luisa Gutierrez joséLuis Lledó Maria Luisa Casas Service of Gastroenterology Hospital Universitario Fundación AlcorcónUniversity King Juan CarlosAv Budapest-128922 AlcorcónMadridSpain Service of Biochemestry Hospital Universitario Fundación AlcorcónUniversity King Juan CarlosAv Budapest-128922 AlcorcónMadridSpain

Persistence of hepatitis B virus-DNA in the sera,peripheral blood mononuclear cells or in the liver of hepatitis B surface antigen(HBsAg) -negative patients with or without serological markers of previous exposure(antibodies to HBsAg and/or to HB-core antigen) defines the entity called occult hepatitis B infection(OBI).Co-infection with hepatitis B and hepatitis C viruses is frequent in highly endemic *** this co-infection increases the risk of liver disease progression,development of cirrhosis and hepatocellular carcinoma and also increases the rate of therapeutic failure to interferon-based treatments than either virus alone,a potentially negative effect of OBI on clinical outcomes and of therapeutic response to current antiviral regimes of patients with chronic hepatitis C remains inconclusive.

关键词： Occult hepatitis B infection Chronic hepatitis C Outcomes

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Creatinine, urea, uric acid, water and electrolytes renal handling in the healthy oldest old

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World Journal of Nephrology 2012年第5期1卷 123-126页

作者： Carlos Guido Musso Joaquín álvarez Gregori josé Ricardo Jauregui juan Florencio Macías Nú?ez Ageing Biology Unit Hospital Italiano of Buenos Aires Gascón 450 Argentina Geriatrics University of Salamanca Calle de los Libreros 25 37008 Salamanca Spain

Renal physiology in the healthy oldest old has the fol-lowing characteristics, in comparison with the renal physiology in the young： a reduced creatinine clear-ance, tubular pattern of creatinine back-fltration, pre-served proximal tubule sodium reabsorption and uric acid secretion, reduced sodium reabsorption in the thick ascending loop of Henle, reduced free water clear-ance, increased urea excretion, presence of medulla hypotonicity, reduced urinary dilution and concentra-tion capabilities, and fnally a reduced collecting tubules response to furosemide which expresses a reduced potassium excretion in this segment due to a sort of aldosterone resistance. All physiological changes of the aged kidney are the same in both genders.

关键词： Ageing Renal Creatinine Urea Uric acid Water Electrolytes Oldest old

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Laparoscopic sleeve gastrectomy:More than a restrictive bariatric surgery procedure?

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World Journal of Gastroenterology 2015年第41期21卷 11804-11814页

作者： David Benaiges Antonio Más-Lorenzo Albert Goday josé M Ramon juan J Chillarón juan Pedro-Botet juana A Flores-Le Roux Department of Endocrinology and Nutrition Hospital del Mar Department of Medicine Universitat Autònoma de Barcelona Institut Hospital del Mar d’Investigacions Mèdiques (IMIM) CiberOBN Instituto de Salud Carlos III Department of Gastrointestinal Surgery Hospital del Mar

Sleeve gastrectomy(SG) is a restrictive bariatric surgery technique that was first used as part of restrictive horizontal gastrectomy in the original Scopinaro type biliopancreatic diversion. Its good results as a single technique have led to a rise in its use, and it is currently the second most performed technique worldwide. SG achieves clearly better results than other restrictive techniques and is comparable in some aspects to the Roux-en-Y gastric bypass, the current gold standard in bariatric surgery. These benefits have been associated with different pathophysiologic mechanisms unrelated to weight loss such as increased gastric emptying and intestinal transit, and activation of hormonal mechanisms such as increased GLP-1 hormone and decreased ghrelin. The aim of this review was to highlight the salient aspects of SG regarding its historical evolution, pathophysiologic mechanisms, main results, clinical applications and perioperative complications.

关键词： Bariatric surgery Sleeve gastrectomy Severe obesit

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Characterizing proteases in an Antarctic Janthinobacterium sp. isolate: Evidence of a protease horizontal gene transfer event

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Advances in Polar Science 2015年第1期26卷 88-95页

作者： Cecilia Martinez-Rosales juan josé Marizcurrena Andrés Iriarte Natalia Fullana Héctor Musto Susana Castro-Sowinski Sección Bioquímica y Biología Molecular Facultad de Ciencias Universidad de la República (Udela R) Igua 4225 11400 Montevideo Uruguay Microbiología Molecular Instituto de Investigaciones Biológicas Clemente Estable (IIBCE).Av Italia 3318 11600Montevideo Uruguay Dpto de Bioquímica y Genómica Microbiana and Dpto de Genómica (IIBCE) Dpto de Desarrollo Biotecnológico Instituto de Higiene Facultad de Medicina Udela R Laboratorio de Organización y Evolución del Genoma Facultad de Ciencias Udela R

We report the isolation of a cold-adapted bacterium belonging to the genus Janthinobacterium （named AU 11）, from a water sample collected in Lake Uruguay （King George Island, South Shetlands）. AUI 1 （growth between 4℃ and 30℃） produces a single cold-active extracellular protease （ExPAU11）, differentially expressed at low temperature. ExPAU11 was identified by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry （MALDI-ToF MS） as an alkaline metallo-protease （70% coverage with an extracellular protease of Janthinobacterium sp. PI12）, and by protease-inhibitor screening identified as a serine-protease. To the best of our knowledge this is the first experimental evidence of a cold-active extracellular protease produced by Janthinobacterium. Furthermore, we identified a serine-protease gene （named JSP8A） showing 60% identity （98% query coverage） to subtilisin peptidases belonging to the $8 family （S8A subfamily） of many cyanobacteria. A phylogenetic analysis of the JSP8A protease, along with related bacterial protein sequences, confirms that JSP8A clusters with S8A subtilisin sequences from different cyanobacteria, and is clearly separated from SSA bacterial sequences of other phyla （including its own）. An analysis of the genomic organization around JSP8A suggests that this protease gene was acquired in an event that duplicated a racemase gene involved in transforming L- to D-amino acids. Our results suggest that AU11 probably acquired this subtilisin-like protease gene by horizontal gene transfer （HGT） from a cyanobacterittrn. We discuss the relevance of a bacterial protease-HGT in the Antarctic environment in light of this hypothesis.

关键词： Antarctic cold-active protease horizontal gene transfer Janthinobacterium subtilisin

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Aortic valve stenosis provides complementary information to bleeding risk scores in non-valvular atrial fibrillation patients initiating anticoagulation

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Journal of Geriatric Cardiology 2020年第3期17卷 141-148,I0005-I0007页

作者： Gines Elvira-Ruiz Cesar Caro-Martinez Pedro joseFlores-Blanco juan joseCerezo-Manchado Helena Albendin-Iglesias Alejandro Lova-Navarro Francisco Arregui-Montoya Francisca Maria Munoz-Franco Natalia Garcia-Iniesta Arcadio Garcia-Alberola joseLuis Bailen-Lorenzo Domingo Andres Pascual-Figal Sergio Manzano-Fernández Department of Cardiology University Hospital Virgen de la ArrixacaMurciaSpain Instituto Murciano de Investigación en Biomedicina(IMIB) MurciaSpain Department of Cardiology University Hospital Morales MeseguerMurciaSpain Department of Hematology University Hospital Virgen de la ArrixacaMurciaSpain Department of Internal Medicine University Hospital Virgen de la ArrixacaMurciaSpain School of Medicine University of MurciaMurciaSpain Department of Cardiology Hospital Vega BajaAlicanteSpain

Background The identification of modifiable bleeding risk factors may be of *** aim is to evaluate if aortic stenosis(AS)provides additional information to bleeding risk scores for predicting major bleeding(MB)in non-valvular atrial fibrillation(AF).Methods We designed a retrospective multi-center study including 2880 consecutive non-valvular AF patients initiating oral anticoagulation between January 2013 and December *** was defined as moderate or severe according to European echocardiography guidelines ***,ATRIA and ORBIT scores were used to evaluate the bleeding *** was defined according to the International Society on Thrombosis and Haemostasia criteria and registered at 18 months of *** 168(5.8%)patients had *** with AS had higher risk for MB compared to those without AS(HR=2.13,95%CI:1.40-3.23,P<0.001).Patients without AS and low-intermediate bleeding risk(0 points)showed the lowest MB rate,whereas the MB rate observed among patients with AS and high bleeding risk(2 points)was the highest *** and reclassification analyses showed that AS provided additional information to bleeding risk scores for predicting MB at 18 months of *** In this population,AS was associated with an increased risk for MB at midterm *** three scoring systems showed a moderate discriminatory ability for ***,the addition of AS was associated with a significant improvement in their predictive *** suggest that the presence of this valvulopathy should be taken into account for bleeding risk assessment.

关键词： Anticoagulants Aortic stenosis Atrial fibrillation Major bleeding Valvular disease

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Comparison of the systemic action of electroacupuncture and laserpuncture in experimental injuries on the back skin of Wistar rats(Rattus novergicus)

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Journal of Traditional Chinese Medicine 2021年第5期41卷 779-788页

作者： Ivens Takechi Nakagawa Hamilton Ricardo Alonso Fabrício Campos Kuroda joséRoberto Passarini Junior juan Guzman Quispe Cabanillas Fernanda Aparecida Sampaio Mendonça Gláucia Maria Tech dos Santos Andrea Aparecida de Aro Edson Rosa Pimentel Maria Esméria Corezola do Amaral Marcelo Augusto Marretto Esquisatto Graduate Program in Biomedical Sciences University Center of Herminio Ometto Foundation-FHOAvenida Dr.Maximiliano Baruto500-Jardim UniversitarioArarasSao Paulo 13607-339Brazil Department of Structural and Functional Biology Institute of BiologyState University of Campinas-UNICAMPAvenida Bertrand Russels/n.Caixa Postal 6109CampinasSao Paulo 13083-865Brazil

OBJECTIVE:To evaluate the systemic action of electroacupuncture and laserpuncture in the repair of excisional cutaneous injuries on the back of adult female Wistar ***:Ninety animals were divided into three experimental groups:C-control;E-treated with electroacupuncture[acupoints:Feishu(BL13),Geshu(BL17),Zusanli(ST36)];L-treated with laserpuncture(same acupoints)and euthanized on the 7 th,14 th and 21 st days for tissue removal and preparation for histomorphometric and biochemical(dosages,zymography and Western blotting)***:The number of fibroblasts in the E and L groups presented higher values than the C on the14 th and 21 st *** number of granulocytes was lower than C on the 21 st day in groups E and *** total number of newly formed vessels increased on the 21 st day and was higher in both treatments when compared to *** birefringent collagen fibers detected on the 21 st day was lower in groups E and L than group *** glycosaminoglycans and hydroxyproline amount was similar among groups throughout the experimental *** active isoform of matrixmetallo proteinase(MMP)-2 and the latent isoform of MMP-9 did not show any differences among all groups and experimental *** amount of collagenⅠpresented higher values in the L group on the 14 th day and in the E and L groups on the 21 st *** typeⅢcollagen,groups E and L presented values lower than C in all experimental *** amount of transforming growth factor-β1 in the E and L groups showed higher amounts than C on the 7 th day and lower on the 14 th and 21 st *** vascular endothelial growth factor,E and L groups presented similar and lower values than C on the 7 th and 14 th days,respectively,and similar on the 21 st ***:The therapies evaluated in this article stimulated fibroblast proliferation,neoangiogenesis and altered the reorganization of collagen fibers in the repair of excisional injuries in female adult rats.

关键词： wound healing electroacupuncture inflammation morphological and morphometric findings

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