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From liver to hormones:The endocrine consequences of cirrhosis

World Journal of Gastroenterology 2024年第9期30卷 1073-1095页

作者： Juan Eduardo Quiroz-Aldave Elman Rolando Gamarra-Osorio María del Carmen Durand-Vásquez luciana del pilar rafael-robles Jhean Gabriel Gonzáles-Yovera María Alejandra Quispe-Flores Luis Alberto Concepción-Urteaga Alejandro Román-González José Paz-Ibarra Marcio José Concepción-Zavaleta Non-communicable Diseases Endocrinology Research LineHospital de Apoyo ChepénChepén 13871Peru Department of Endocrinology Hospital Víctor Lazarte EchegarayTrujillo 13006Peru Department of Endocrinology Clínica Javier PradoLima 15046Peru Department of Gastroenterology Hospital Nacional Guillermo Almenara IrigoyénLima 15018Peru Department of Endocrinology Hospital de Emergencias GrauLima 15001Peru Internal Medicine Hospital Regional Docente de TrujilloTrujillo 13011Peru Department of Endocrinology Hospital Universitario de San Vicente FundaciónMedellin 050010Colombia Internal Medicine Universidad de AntioquiaMedellín 050010Colombia School of Medicine Universidad Nacional Mayor de San MarcosLima 15081Peru Department of Endocrinology Hospital Nacional Edgardo Rebagliati MartinsLima 15072Peru Carrera de Medicina Humana Universidad Científica del SurLima 15067Peru

Hepatocrinology explores the intricate relationship between liver function and the endocrine *** liver diseases such as liver cirrhosis can cause endocrine disorders due to toxin accumulation and protein synthesis *** its importance,assessing endocrine issues in cirrhotic patients is frequently *** article provides a comprehensive review of the epidemiology,pathophysiology,diagnosis,and treatment of endocrine disturbances in liver *** review was conducted using the PubMed/Medline,EMBASE,and Scielo databases,encompassing 172 *** cirrhosis is associated with endocrine disturbances,including diabetes,hypoglycemia,sarcopenia,thyroid dysfunction,hypogonadotropic hypogonadism,bone disease,adrenal insufficiency,growth hormone dysfunction,and secondary *** optimal tools for diagnosing diabetes and detecting hypoglycemia are the oral glucose tolerance test and continuous glucose monitoring system,*** can be assessed through imaging and functional tests,while other endocrine disorders are evaluated using hormonal assays and imaging *** options include metformin,glucagon-like peptide-1 analogs,sodium-glucose co-transporter-2 inhibitors,and insulin,which are effective and safe for diabetes *** standards are followed for managing hypoglycemia,and hormone replacement therapy is often necessary for other endocrine *** transplantation can address some of these problems.

关键词： Diabetes mellitus Hypoglycemia Thyroid diseases Hypogonadism Metabolic bone diseases Liver cirrhosis

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Diabetic gastroenteropathy:An underdiagnosed complication

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World Journal of Diabetes 2021年第6期12卷 794-809页

作者： Marcio JoséConcepción Zavaleta Jhean Gabriel Gonzáles Yovera Diego Martín Moreno Marreros luciana del pilar rafael robles Kely Roxana Palomino Taype Karen Nohelly Soto Gálvez Luis Fernando Arriola Torres Julia Cristina Coronado Arroyo Luis Alberto Concepción Urteaga Division of Endocrinology Hospital Nacional Guillermo Almenara IrigoyenLima 12590Peru Division of Gastroenterology Hospital Nacional Guillermo Almenara IrigoyenLima 12590Peru Division of Medicine Universidad Nacional de TrujilloTrujillo 13011Peru Division of Endocrinology Hospital Nacional Dos de MayoLima 150101Peru Division of Endocrinology Instituto de Neurología y Endocrinología AvanzadaAndahuaylas 03700Peru Clinical Management Unit Hospital Nacional Guillermo Almenara IrigoyenLima 12590Peru Division of Neurology Instituto de Neurología y Endocrinología AvanzadaAndahuaylas 03700Peru Division of Obstetrics and Gynaecology Clínica VesalioLima 15036Peru Division of Neumology Hospital Regional Docente de TrujilloTrujillo 13011Peru

This article is an extensive review that provides an update on the pathophysiology,symptoms,diagnosis,and treatment of diabetic *** is no reported prevalence,but it has been described that patients with type 1 diabetes have a cumulative incidence at 10 years of 5.2%,and type 2 patients,1%.Also,in the group of type 1 diabetes,it has been observed that women are more likely to present this condition(5.8%vs 3.5%).Many factors are associate with its development(e.g.,hyperglycemia,vagal dysfunction,loss of expression of neural nitric oxide synthase in the myenteric plexus,alterations in the Cajal interstitial cell network,and oxidative stress).Gastrointestinal discomfort could be perceived 70% higher in diabetic patients,describing that 25%of diabetic patients experience gastrointestinal *** enteropathy could affect any portion of the gastrointestinal tract,but esophageal alterations were described in more than 60% of diabetic patients,also 60% of them present constipation,and 20%,*** emptying scintigraphy is useful to evaluate gastroparesis,therefore,gastric retention of more than 60%at 2 h has a sensitivity of 100% and specificity of 20% for diagnosis;however,other studies such as breath tests,with a sensitivity of 89% and a specificity of 80%,or the endoscopic capsule contribute to the *** is no cure;however,management must be multidisciplinary,focused on slowing the progression of diabetic gastroenteropathy,reducing symptoms,and restoring function;that includes nutritional recommendation,maintain glucose levels kept below 180 mg/dL,use of prokinetics,anti-emetics;nowadays,it has been special interest in surgical treatment,such as pyloroplasty,also gastric electrical stimulation appears to be another alternative.

关键词： Gastroenteropathy Gastroparesis Diabetes mellitus Complication Gastrointestinal disease Treatment

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Novel human immunomodulatory T cell receptors and their double-edged potential in autoimmunity,cardiovascular disease and cancer

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Cellular & Molecular Immunology 2021年第4期18卷 919-935页

作者： pilar Martin rafael Blanco-Dom fnguez Raquel Sanchez-Diaz Vascular Pathophysiology Area Centro Nacional de Investigaciones Cardiovasculares(CNIC)MadridSpain CIBERCV MadridSpain

In the last decade,approaches based on T cells and their immunomodulatory receptors have emerged as a solid improvement in treatments for various types of ***,the roles of these molecules in the therapeutic context of autoimmune and cardiovascular diseases are still relatively ***,we review the best known and most com m only used immunomodulatory T cell receptors in clinical practice(PD-1 and CTLA-4),along with the rest of the receptors with known functions in animal models,which have great potential as modulators in human pathologies in the medium *** ong these other receptors is the receptor CD69,which has recently been described to be expressed in mouse and human T cells in autoimmune and cardiovascular diseases and ***,inhibition of these receptors individually or in combination by drugs or monoclonal antibodies generates a loss of immunological tolerance and can trigger multiple autoimmune disorders in different organs and immune-related adverse *** the coming decades,knowledge on the functions of different immunomodulatory receptors will be pivotal for the development of new and better therapies with less harmful side *** this review,we discuss the roles of these receptors in the control of immunity from a perspective focused on therapeutic potential in not only cancer but also autoimmune diseases,such as systemic lupus erythematosus,autoimmune diabetes and rheumatoid arthritis,and cardiovascular diseases,such as atherosclerosis,acute myocardial infarction,and myocarditis.

关键词： Immunomodulatory receptors Autoimmune diseases T cells Immunotherapy

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Insects as alternative feed for ruminants:comparison of protein evaluation methods

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Journal of Animal Science and Biotechnology 2022年第4期13卷 1143-1150页

作者： Pablo G.Toral Gonzalo Hervás Mariana Gabriela González-Rosales Alejandro G.Mendoza Lizbeth E.robles-Jiménez pilar Frutos Instituto de Ganadería de Montaña(CSIC-University of León) Finca Marzanas s/n24346 GrullerosLeónSpain Facultad de Medicina Veterinaria y Zootecnia Universidad Autónoma del Estado de MéxicoNo.100 Instituto Literario 100Col.Centro50000 TolucaEstado de MéxicoMexico.

Background:The high dependence of intensive ruminant production on soybean meal and the environmental impact of this crop encourage the search for alternative protein-rich *** use of insects seems promising,but the extent of their ruminal protein degradation is largely *** parameter has major influence not only on N utilization efficiency but also on the environmental burden of ruminant *** addition,although assessing ruminal N degradation represents a key first step to examine the potential of new feeds,it is a challenging task due to the lack of a reference *** study was conducted to investigate the potential of 4 insects(Tenebrio molitor,Zophobas morio,Alphitobius diaperinus and Acheta domesticus)as alternative protein sources for ruminants,using 3 methodologies:1)a regression technique based on the in vitro relationship between gas production and ammonia-N concentration;2)a conventional in vitro technique of batch cultures of ruminal microorganisms,based on filtering the incubation residue through sintered glass crucibles;and 3)the in situ nylon bag *** in vitro intestinal digestibility of the non-degraded protein in the rumen was also *** meal was used as a reference ***:Comparison of evaluation methods(regression,in vitro and in situ)did not allow to reliably select a single value of ruminal N degradation for the studied substrates,but all techniques seem to establish a similar ranking,with good correlations between methods,particularly between regression and in situ *** of the methodology,nitrogen from the 4 insects(with contents ranging from 81 to 112 g/kg of dry matter)did not show high ruminal degradation(41–76%),this value being always lower than that of soybean ***,the in vitro intestinal digestibility of non-degraded N was relatively high in all feeds(≥64%).Conclusion:Overall,these results support the potential of the 4 studied insects as alternative feedstu

关键词： In situ In vitro Livestock Nitrogen degradation Sheep

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Therapy with stem cells in inflammatory bowel disease

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World Journal of Gastroenterology 2014年第5期20卷 1211-1227页

作者： María del pilar Martínez-Montiel Gonzalo Jesús Gómez-Gómez Ana Isabel Flores IBD Unit Department of Gastroenterology Universitary Hospital 12 Octubre Medicine Regenerative Group Investigation Center 12 Octubre Investigation Institute

Inflammatory bowel disease (IBD) affects a part of the young population and has a strong impact upon quality of life. The underlying etiology is not known, and the existing treatments are not curative. Furthermore, a significant percentage of patients are refractory to therapy. In recent years there have been great advances in our knowledge of stem cells and their therapeutic applications. In this context, autologous hematopoietic stem cell transplantation (HSCT) has been used in application to severe refractory Crohn’s disease (CD), with encouraging results. Allogenic HSCT would correct the genetic defects of the immune system, but is currently not accepted for the treatment of IBD because of its considerable risks. Mesenchymal stem cells (MSCs) have immune regulatory and regenerative properties, and low immunogenicity (both autologous and allogenic MSCs). Based on these properties, MSCs have been used via the systemic route in IBD with promising results, though it is still too soon to draw firm conclusions. Their local administration in perianal CD is the field where most progress has been made in recent years, with encouraging results. The next few years will be decisive for defining the role of such therapy in the management of IBD.

关键词： Mesenchymal stem cell, Inflammatory bowel disease, Crohn’ s disease, Ulcerative colitis, Haematopoietic stem cell transplantation

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Current approach to treatment of minimal hepatic encephalopathy in patients with liver cirrhosis

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World Journal of Gastroenterology 2021年第22期27卷 3050-3063页

作者： Segundo Moran Marlene López-Sánchez María del pilar Milke-García Gustavo Rodríguez-Leal Laboratory of Hepatology Research Centro Médico NacionalSiglo XXIMexican Institute of Social SecurityMexico City 06720Mexico Division of Nutrition National Institute of NutritionSalvador ZubiránMexico City 14080Mexico

Minimal hepatic encephalopathy(MHE)corresponds to the earliest stage of hepatic encephalopathy(HE).MHE does not present clinically detectable neurological-psychiatric abnormalities but is characterized by imperceptible neurocognitive alterations detected during routine clinical examination via neuropsychological or psychometrical *** may affect daily activities and reduce job performance and quality of *** can increase the risk of accidents and may develop into overt encephalopathy,worsening the prognosis of patients with liver *** a lack of consensus on the therapeutic indication,interest in finding novel strategies for prevention or reversion has led to numerous clinical trials;their results are the main objective of this *** studies address the treatment of MHE,which is mainly based on the strategies and previous management of overt *** alternatives for the management of MHE include measures to maintain nutritional status while avoiding sarcopenia,and manipulation of intestinal microbiota with non-absorbable disaccharides such as lactulose,antibiotics such as rifaximin,and administration of different *** review analyzes the results of clinical studies that evaluated the effects of different treatments for MHE.

关键词： Minimal hepatic encephalopathy Sarcopenia Probiotics Non-absorbable disaccharides,Rifaximin L-ornithine-L-aspartate

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Holistic Disaster Risk Evaluation for the Urban Risk Management Plan of Manizales,Colombia

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International Journal of Disaster Risk Science 2017年第3期8卷 258-269页

作者： Martha Liliana Carreno Omar-Darío Cardona Alex H.Barbat Dora Catalina Suarez María del pilar Perez Lizardo Narvaez Centre Internacional de Metodes Numerics en Enginyeria Universitat Politècnica de Catalunya Instituto de Estudios Ambientales (IDEA) Universidad Nacional de Colombia Sede Manizales INGENIAR Ltda

Disaster risk depends on both the physical vulnerability and a wide range of social, economic, and environmental aspects of a society. For a better risk understanding, a holistic or integrated perspective was considered when risk was assessed for the city of Manizales, Colombia. This assessment accounts not only for the expected physical damage and loss, but also for the socioeconomic vulnerability factors that favor secondorder effects in a disaster. This comprehensive approach allows the identification of different aspects related to physical vulnerability, social fragility, and lack of resilience that can be improved, thus enhancing integrated disaster risk management actions. The outcomes of this comprehensive assessment are currently being used as input to update the disaster risk management plan of Manizales.

关键词： Holistic risk assessment Manizales (Colombia) Probabilistic risk assessment Risk management plan Urban disaster risk index Urban resilience

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Hydatid cyst of the gallbaldder: A systematic review of the literature

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World Journal of Hepatology 2016年第25期8卷 1087-1092页

作者： Roberto Gómez Yousef Allaoua rafael Colmenares Sergio Gil pilar Roquero José M Ramia Faculty of Medicine Universidad de Alcalá Servicio de Cirugía General y del Aparato Digestivo Hospital Universitario de Guadalajara

AIM To evaluate all the references about primary gallbladder hidatidosis looking for best treatment *** Search:1966-2015 in MEDLINE,Cochrane Library,SciELO,and *** words: "gallabladder hydatid disease" and "gallbladder hydatid cyst".We found 124 papers in our searches but only 14 papers including 16 cases were about hydatid cyst of the gallbladder(GBHC).RESULTS Eight cases of GBHC were women and seven *** not *** age was 48.3 *** most frequent clinical symptom was abdominal pain(94%) usually in the right upper *** was performed in ten patients(62.5%) but in most cases a combination of several techniques was *** location of the cysts was intravesicular in five *** patients presented GBHC and liver hydatid *** patients presented cholelithiasis and one *** most frequent surgical technique was cholecystectomy by laparotomy(81.25%).Simultaneous surgery of liver cysts was carried out in five *** patients did not present postoperative complications,but one *** mean hospital stay was seven *** recurrence of GBHC was *** In GBHC,the most frequent symptom is right hypocondrium pain(evidence level V).Best diagnostic methods are ultrasound and computed tomography(level V,grade D).Suggested treatment is open cholecystectomy and postoperative albendazole(level V,grade D) obtaining good clinical results and none relapses.

关键词： Hydatid cyst Gallbladder Cholecystectomy Review Hydatidosis

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Clinical outcomes with a new design in multifocal intraocular lens:a pilot study

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Eye and Vision 2020年第5期7卷 366-374页

作者： Jorge L.Alió pilar Yébana Mario Cantó Ana B.Plaza Alfredo Vega Jorge L.Aliódel Barrio Francisco Lugo Vissum Corporation Avda de Denia s/nEdificio Vissum03016 AlicanteSpain Division of Ophthalmology Universidad Miguel HernándezAlicanteSpain

Purpose:To evaluate the clinical and visual outcomes,quality of near vision and the influence of photic phenomena in patients bilaterally implanted with a new Precizon Presbyopic multifocal intraocular lens(IOL).Methods:In this prospective consecutive case series,20 eyes of 10 patients were included(mean age 63.80±12.55 years).Uncorrected and corrected visual acuity(far,intermediate and near),subjective refraction,binocular defocus curve,contrast sensitivity(CSV-1000)and quality of vision and satisfaction questionnaires were *** follow-up was 12 months after ***:At 12 months after surgery,uncorrected distance visual acuity(UDVA)improved with surgery(p=0.001)with a value of 0.08±0.08 *** near visual acuity(UNVA)was 0.22±0.12 logMAR and distance corrected near visual acuity(DCNVA)was 0.16±0.13 *** distance visual acuity(UIVA)was 0.22±0.10 *** sensitivity outcomes were similar to normal population in photopic conditions and slightly reduced in mesopic conditions of *** curve showed that this multifocal IOL was able to provide a visual acuity(VA)equal or better to 0.16 logMAR between defocus levels of+1.00 to−2.50 *** patient satisfaction was obtained in quality of vision and satisfaction questionnaires ***:The Precizon Presbyopic NVA IOL(OPHTEC BV)provides good visual *** multifocal IOL provides a high percentage of spectacle independence due to good VA at far,intermediate and near distances and satisfactory contrast *** patient satisfaction was observed in quality of vision and satisfaction questionnaires with a low percentage of patients manifesting photic phenomena.

关键词： Multifocal intraocular lens Near vision Photic phenomena Continuous transitional focus optic

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Intense pulsed light‑based treatment for the improvement of symptoms in glaucoma patients treated with hypotensive eye drops

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Eye and Vision 2024年第2期10卷 12-21页

作者： Jose Maria Martinez‑de‑la‑Casa Carlos Oribio‑Quinto Almudena Milans‑del‑Bosch pilar Perez‑Garcia Laura Morales‑Fernandez Javier Garcia‑Bella Jose Manuel Benitez‑del‑Castillo Julian Garcia‑Feijoo David P.Pinero Ophthalmology Unit Department of Ophthalmology and ORLFaculty of MedicineHospital Clinico San-CarlosUniversidad Complutense de MadridInstituto de Investigacion Sanitaria del Hospital Clinico San-Carlos(IdISSC)28040 MadridSpain Department of Immunology Ophthalmology and ORLSchool of MedicineInstituto de Investigaciones Oftalmologicas Ramon CastroviejoUniversidad Complutense de MadridMadridSpain Department of Optics Pharmacology and AnatomyUniversity of AlicanteAlicanteSpain

Background:Ocular surface disease in glaucoma patients is a significant ocular co-morbidity that can affect 40%to 59%of these patients *** current study was aimed at evaluating the potential clinical benefit of an intense pulsed light(IPL)-based treatment in glaucomatous patients with ocular surface disease due to prolonged hypotensive eyedrop *** our knowledge,this is the first series analyzing the therapeutic effect of this treatment option in this type of ***:This non-comparative prospective case series study enrolled a total of 30 glaucoma patients ranging in age from 57 to 94 years old and treated with hypotensive eyedrops for years with dry eye *** patients received four sessions of IPL treatment using the Optima IPL system(Lumenis,Yokneam,Israel)adjusted to the official optimized Lumenis *** in symptomatology,corneal staining,conjunctival hyperemia,non-invasive break-up time(NIBUT),tear osmolarity,tear meniscus height(TMH),meiboscore and meibomian gland expressibility was analyzed after ***:Statistically significant reductions were observed after IPL treatment in the symptomatology scores measured with different questionnaires[ocular surface disease index(OSDI),standard patient evaluation of eye dryness(SPEED)and symptom assessment questionnaire in dry eye(SANDE)]as well as with the visual analogue scale(P<0.001).Mean change in OSDI was−15.0±11.3.A significant reduction was found after treatment in the corneal staining score(P<0.001).A significant reduction was found in tear film meniscus height(P=0.012),as well as in tear film osmolarity(P=0.001).A significant reduction was also found in meibomian gland expressibility(P=0.003),changing the percentage of grade 3 eyes from 44.4%before IPL to 17.2%after ***:IPL therapy combined with meibomian gland expression(MGX)seems to be an effective option to improve symptomatology in glaucomatous patients with ocular surface diseas

关键词： Glaucoma Intense pulsed light Dry eye Meibomian glands

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