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Blood transfusion for the treatment of acute anaemia in inflammatory bowel disease and other digestive diseases

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World Journal of Gastroenterology 2009年第37期15卷 4686-4694页

作者： José Antonio García-Erce Fernando Gomollón manuel muoz Transfusion Medicine and Apheresis Unit Haematology and Haemotherapy Regional Service "Miguel Servet" University Hospital Zaragoza 50009 Spain Gastroenterology Unit University Clinical Hospital and Biomedical Investigation Center at Digestive and Hepatic Disease Network c/San Juan Bosco 15 Zaragoza 50009 Spain Transfusion Medicine School of Medicine University of Málaga Málaga 29071 Spain

Allogeneic blood transfusion (ABT) is frequently used as the first therapeutic option for the treatment of acute anaemia in patients with inflammatory bowel disease (IBD), especially when it developed due to gastrointestinal or perioperative blood loss, but is not risk-free. Adverse effects of ABT include, but are not limited to, acute hemolytic reaction (wrong blood or wrong patient), febrile non-hemolytic transfusional reaction, bacterial contamination, transfusion-related acute lung injury, transfusion associated circulatory overload, transfusion-related immuno-modulation, and transmission of almost all infectious diseases (bacteria, virus, protozoa and prion), which might result in increased risk of morbidity and mortality. Unfortunately, the main physiological goal of ABT, i.e. to increase oxygen consumption by the hypoxic tissues, has not been well documented. In contrast, the ABT is usually misused only to increase the haemoglobin level within a f ixed protocol [mostly two by two packed red blood cell (PRC) units] independently of the patient' s tolerance to normovolemic anaemia or his clinical response to the transfusion of PRC units according to a "one-by-one" administration schedule. Evidencebased clinical guidelines may promote best transfusion practices by implementing restrictive transfusion protocols, thus reducing variability and minimizing the avoidable risks of transfusion, and the use of autologous blood and pharmacologic alternatives. In this regard, preoperative autologous blood donation (PABD) consistently diminished the frequency of ABT, although its contribution to ABT avoidance is reduced when performed under a transfusion protocol. In addition, interpretation of utility of PABD in surgical IBD patients is hampered by scarcity of published data. However, the role of autologous red blood cells as drug carriers is promising. Finally, it must be stressed that a combination of methods used within wellconstructed protocols will offer better prospe

关键词： Anaemia Blood transfusion Autologous blood transfusion Inflammatory bowel diseases Risk assessment

Intravenous iron in inflammatory bowel disease

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World Journal of Gastroenterology 2009年第37期15卷 4666-4674页

作者： manuel muoz Susana Gómez-Ramírez José Antonio García-Erce Transfusion Medicine School of Medicine University of Málaga Málaga 29071 Spain Department of Internal Medicine University Hospital Virgen de la Victoria Málaga 29010 Spain Department of Hematology and Hemoterapy University Hospital Miguel Servet Zaragoza 50008 Spain

The prevalence of anemia across studies on patients with inflammatory bowel disease (IBD) is high (30%). Both iron defi ciency (ID) and anemia of chronic disease contribute most to the development of anemia in IBD. The prevalence of ID is even higher (45%). Anemia and ID negatively impact the patient's quality of life. Therefore, together with an adequate control of disease activity, iron replacement therapy should start as soon as anemia or ID is detected to attain a normal hemoglobin (Hb) and iron status. Many patients will respond to oral iron, but compliance may be poor, whereas intravenous (IV) compounds are safe, provide a faster Hb increase and iron store repletion, and presents a lower rate of treatment discontinuation. Absolute indications for IV iron treatment should include severe anemia, intolerance or inappropriate response to oral iron, severe intestinal disease activity, or use of an erythropoietic stimulating agent. Four different products are principally used in clinical practice, which differ in their pharmacokinetic properties and safety profi les: iron gluconate and iron sucrose (lower single doses), and iron dextran and ferric carboxymaltose (higher single doses). After the initial resolution of anemia and the repletion of iron stores, the patient's hematological and iron parameters should be carefully and periodically monitored, and maintenance iron treatment should be provided as required. New IV preparations that allow for giving 1000-1500 mg in a single session, thus facilitating patient management,provide an excellent tool to prevent or treat anemia and ID in this patient population, which in turn avoids allogeneic blood transfusion and improves their quality of life.

关键词： Inflammatory bowel disease Anemia Iron deficiency Functional iron deficiency Erythropoiesisstimulating agents Oral iron Intravenous iron

Perioperative anemia management in colorectal cancer patients:A pragmatic approach

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World Journal of Gastroenterology 2014年第8期20卷 1972-1985页

作者： manuel muoz Susana Gómez-Ramírez Elisa Martín-Montaez Michael Auerbach Transfusion Medicine School of MedicineUniversity of Málaga29071-MálagaSpain Internal Medicine University Hospital Virgen de la Victoria29071-MálagaSpain Department of Pharmacology School of MedicineUniversity of Málaga29071-MálagaSpain Georgetown University School of Medicine WashingtonDC 20057United States

Anemia,usually due to iron deficiency,is highly prevalent among patients with colorectal *** cytokines lead to iron restricted erythropoiesis further decreasing iron availability and impairing iron *** anemia predicts for decreased *** blood transfusion is widely used to correct anemia and is associated with poorer surgical outcomes,increased post-operative nosocomial infections,longer hospital stays,increased rates of cancer recurrence and perioperative venous *** are more likely to occur in those with low preoperative serum ferritin level compared to those with normal levels.A multidisciplinary,multimodal,individualized strategy,collectively termed Patient Blood Management,minimizes or eliminates allogeneic blood *** includes restrictive transfusion policy,thromboprophylaxis and anemia management to improve *** of preoperative hemoglobin levels is a World Health Organization *** repletion should be routinely ordered when *** iron is poorly tolerated with low adherence based on published *** iron is safe and effective but is frequently avoided due to misinformation and misinterpretation concerning the incidence and clinical nature of minor infusion *** adverse events with intravenous iron are extremely *** formulations allow complete replacement dosing in 15-60 min markedly facilitating *** stimulating agents may improve response rates.A multidisciplinary,multimodal,individualized strategy,collectively termed Patient Blood Management used to minimize or eliminate allogeneic blood transfusion is indicated to improve outcomes.

关键词： Colorectal cancer Anemia Allogeneic blood transfusion Intravenous iron Erythropoiesis stimulating agents Patient Blood Management

Up to Date Management of DCIS and Future Directions

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Advances in Breast Cancer Research 2020年第3期9卷 78-100页

作者： Rodrigo Arrangoiz Fernando Cordera Eduardo Moreno Enrique Luque-de-Leon manuel muñoz Sociedad Quirúrgica S.C. at the American British Cowdray Medical Center Colonia Tlaxala Delegación Cuajimalpa Mexico City Mexico

Ductal carcinoma in situ (DCIS) is a non-invasive malignancy confined within the basement membrane of the breast ductal system. There is a lot of disparity in the natural history of DCIS with an estimated incidence of progression to invasive ductal carcinoma between 20% to 53% over ten or more years after initial diagnosis. The surgical and adjuvant management of DCIS has advanced significantly in the last couple of decades. Nonetheless, surgeons, medical oncologists, and radiation oncologists, along with their patients, still depend on conventional clinical and pathologic risk factors to make management decisions. Irrespective of the management strategy, long-term survival is excellent. The debate around DCIS relates to preventing either under-treatment or over-treatment. In this paper, we will review the incidence and management options of DCIS. Additionally, we will focus on several current disputes related to the management of DCIS, including breast conserving surgery, the role of radiation in breast conservation surgery, sentinel node biopsy in DCIS, hor

关键词： Ductal Carcinoma in Situ DCIS Management of DCIS Treatment of DCIS Predictors of Recurrence of DCIS Risk Stratification Schemes for DCIS Active Surveillance for DCIS

Persistent Abdominal Pain Associated with Splenic Lymphangioma in An Adult Patient: A Case Presentation

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Journal of Biosciences and Medicines 2024年第9期12卷 82-88页

作者： David Fernando Ortiz Pérez Janne Jorgeth Fabregas Ramirez Mario Enrique Montoya Jaramillo Juan José Iles Bravo John Sebastián Osorio muñoz manuel Fernando Chavarro muñoz Daniel de Jesús González Villarreal manuel Esteban Ortiz Pérez Department of Internal Medicine Cartagena del Mar Clinical Center Cartagena Colombia

Splenic lymphangioma is a rare benign lesion, predominantly seen in the pediatric population and exceptionally in adults. It is usually associated with lymphatic system malformations caused by secondary lymphangiectasia due to abnormal communication between lymphatic ducts. It often coexists with complex clinical syndromes, such as Klippel-Trenaunay syndrome, congenital epithelial cysts, or, in less frequent conditions, infectious or post-traumatic triggering events. It typically presents in the neck or axillae, with intra-abdominal cases accounting for less than 5% of all cases. We present the clinical case of a 44-year-old male patient who presented with a clinical course of approximately one month, characterized by progressive abdominal pain associated with nausea, multiple episodes of emesis, anorexia, and involuntary weight loss. A diagnostic laparoscopy was performed, revealing a poorly differentiated lesion in the splenic topography, for which a biopsy was performed, leading to the definitive diagnosis. In this scenario, splenic lymphangioma should be considered among the differential diagnoses of persistent abdominal pain, and definitive interventions should be determined based on clinical characteristics.

关键词： Lymphangioma Neoplasms Splenic Neoplasms Laparoscopy Adulthood

Association between lifestyle factors and thyroid function in young euthyroid adults

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Food Science and Human Wellness 2024年第1期13卷 265-275页

作者： Elisa Merchan-Ramirez Guillermo Sanchez-Delgado Lucas Jurado-Fasoli Francisco M Acosta manuel munoz-Torres Jose M.Llamas-Elvira Jonatan R Ruiz Sport and Health University Research Institute(imuDS) Faculty of Sports ScienceUniversity of GranadaGranada 18016Spain Pennington Biomedical Research Center Baton Rouge 70808USA Faculty of Medicine University of GranadaGranada 18071Spain Turku PET Centre University of TurkuTurku 20500Finland Turku PET Centre Turku University HospitalTurku 20520Finland Biosanitary Research Institute of Granada(Ibs.Granada) Granada 18012Spain CIBERFES Instituto de Salud CarlosⅢMadrid 28029Spain Endocrinology and Nutrition Service University Hospital San CecilioGranada 18016Spain Nuclear Medicine Service "Virgen de las Nieves"University HospitalGranada 18014Spain

Purpose:The present work examines the associations of dietary habits,sedentarism,physical activity(PA)levels and sleep habits,with thyroid function in young euthyroid ***:A total of 105 young euthyroid adults participated in this cross-sectional *** function was determined in fasting conditions(>6 h).Dietary habits were measured by a food frequency questionnaire and three non-consecutive 24 h recalls,and different dietary intake and patterns were then *** time spent in sedentary,PA levels and sleep habits were objectively measured using a wrist-worn ***:Energy and carbohydrate intake were positively associated with thyroid stimulating hormone(TSH)(β=0.222;R^(2)=0.102;P=0.022 andβ=0.425;R^(2)=0.129;P=0.007,respectively)whereas fat intake was negatively associated with TSH(β=-0.428;R^(2)=0.137;P=0.004).Energy intake was also positively associated with free triiodothyronine(β=0.277;R^(2)=0.137;P=0.004).Further,adherence to the Mediterranean diet was negatively related to TSH and free thyroxine(FT4)(β=-0.221;R^(2)=0.113;P=0.020 andβ=-0.268;R^(2)=0.071;P=0.007,respectively).Vigorous-intensity and overall PA were negatively associated with FT4(β=-0.227;R^(2)=0.052;P=0.022 andβ=-0.204;R^(2)=0.042;P=0.041,respectively).In contrast,no associations were found between sleep parameters and thyroid ***:Lifestyle factors such as dietary intake and PA levels seems to be related to thyroid function even in young euthyroid adults.

关键词： Thyroid hormones Dietary intake Sleep Physical activity Euthyroid

Association between lifestyle factors and thyroid function in young euthyroid adults

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Food Science and Human Wellness 2022年

作者： Elisa Merchan-Ramirez Guillermo Sanchez-Delgado Lucas Jurado-Fasoli Francisco M Acosta manuel mu?oz-Torres Jose M.Llamas-Elvira Jonatan R Ruiz Nuclear Medicine Service， "Virgen de las Nieves" University Hospital Sport and Health University Research Institute (imuDS)， Faculty of Sports Science， University of Granada Pennington Biomedical Research Center School of Medicine， University of Granada Turku PET Centre， University of Turku Turku PET Centre， Turku University Hospital Instituto de Investigación Biosanitaria Granada (Ibs.Granada) Department of Medicine， University of Granada Endocrinology and Nutrition Service， University Hospital San Cecilio

Purpose: The present work examines the associations of dietary habits， sedentarism， physical activity (PA) levels and sleep habits， with thyroid function in young euthyroid adults. Methods: A total of 105 young euthyroid adults participated in this cross-sectional study. Thyroid function was determined in fasting conditions (> 6 h). Dietary habits were measured by a food frequency questionnaire and three non-consecutive 24 h recalls， and different dietary intake and patterns were then estimated. The time spent in sedentary， PA levels and sleep habits were objectively measured using a wrist-worn accelerometer. Results: Energy and carbohydrate intake were positively associated with thyroid stimulating hormone (TSH) (β = 0.222; R2= 0.102; P = 0.022 and β = 0.425; R2= 0.129; P = 0.007， respectively) whereas fat intake was negatively associated with TSH (β = -0.428; R2= 0.137; P = 0.004). Energy intake was also positively associated with free triiodothyronine (β = 0.277; R2= 0.137; P = 0.004). Further， adherence to the Mediterranean diet was negatively related to TSH and free thyroxine (FT4) (β = -0.221; R2= 0.113; P = 0.020 and β = -0.268; R2= 0.071; P = 0.007， respectively). Vigorous-intensity and overall PA were negatively associated with FT4 (β = -0.227; R2= 0.052; P = 0.022 and β = -0.204; R2= 0.042; P = 0.041， respectively). In contrast， no associations were found between sleep parameters and thyroid function. Conclusions: Lifestyle factors such as dietary intake and PA levels seems to be related to thyroid function in young euthyroid adults.

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Differential response of injured and healthy retinas to syngeneic and allogeneic transplantation of a clonal cell line of immortalized olfactory ensheathing glia:a double-edged sword

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Neural Regeneration Research 2025年第8期20卷 2395-2407页

作者： María Norte-muñoz María Portela-Lomba Paloma Sobrado-Calvo Diana Simón Johnny Di Pierdomenico Alejandro Gallego-Ortega Mar Pérez JoséMCabrera-Maqueda Javier Sierra manuel Vidal-Sanz María Teresa Moreno-Flores Marta Agudo-Barriuso Grupo de Investigación Oftalmología Experimental Departamento de OftalmologíaOptometríaOtorrinolaringología y Anatomía PatológicaFacultad de MedicinaUniversidad de MurciaInstituto Murciano de Investigación Biosanitaria(IMIB)Campus de Ciencias de la SaludMurciaSpain Experimental Sciences Faculty Universidad Francisco de VitoriaPozuelo de AlarcónMadridSpain Anatomy Histology and Neuroscience DepartmentMedicine FacultyUniversidad Autónoma de MadridMadridSpain Center of Neuroimmunology Service of NeurologyLaboratory of Advanced Imaging in Neuroimmunological DiseasesHospital Clínic of BarcelonaInstitut d’Investigacions Biomèdiques August Pi i Sunyer(IDIBAPS)and Universitat de BarcelonaBarcelonaSpain Medicine Faculty Universidad Francisco de VitoriaPozuelo de AlarcónMadridSpain

Olfactory ensheathing glia promote axonal regeneration in the mammalian central nervous system,including retinal ganglion cell axonal growth through the injured optic ***,it is unknown whether olfactory ensheathing glia also have neuroprotective *** ensheathing glia express brain-derived neurotrophic factor,one of the best neuroprotectants for axotomized retinal ganglion ***,we aimed to investigate the neuroprotective capacity of olfactory ensheating glia after optic nerve *** ensheathing glia cells from an established rat immortalized clonal cell line,TEG3,were intravitreally injected in intact and axotomized retinas in syngeneic and allogeneic mode with or without microglial inhibition or immunosuppressive *** and gene expression analyses were *** bulb-derived primary olfactory ensheathing glia and TEG3 express major histocompatibility complex classⅡ*** and syngenically transplanted TEG3 cells survived in the vitreous for up to 21 days,forming an *** axotomized retinas,only the allogeneic TEG3 transplant rescued retinal ganglion cells at 7 days but not at 21 *** these retinas,microglial anatomical activation was higher than after optic nerve crush *** intact retinas,both transplants activated microglial cells and caused retinal ganglion cell death at 21 days,a loss that was higher after allotransplantation,triggered by pyroptosis and partially rescued by microglial inhibition or ***,neuroprotection of axotomized retinal ganglion cells did not improve with these *** different neuroprotective properties,different toxic effects,and different responses to microglial inhibitory treatments of olfactory ensheathing glia in the retina depending on the type of transplant highlight the importance of thorough preclinical studies to explore these variables.

关键词： cell therapy immune recognition major histocompatibility complex class II(MHCII) neuroprotection olfactory ensheathing glia retinal ganglion cells

Effect of Ultraviolet Radiation on Hsp70 Protein Expression in HaCaT Cells

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World Journal of Nuclear Science and Technology 2024年第1期14卷 59-71页

作者： Sergio Hugo Sánchez Rodríguez Jesús Rodríguez Vergil manuel Venancio muñoz Juárez Kevin Said Ramírez Dávila Luis Martín García Ortiz Germán Flores Cortés Luz Elena Vidales Rodríguez Jesús Adrián López David Alejandro García López Laboratorio de Biología Celular y Neurobiología Unidad Académica de Ciencias Biológicas Universidad Autónoma de Zacatecas Zacatecas México Laboatorio de Bacterias y Hongos Filamentosos Unidad Académica de Ciencias Biológicas Universidad Autónoma de Zacatecas Zacatecas México Laboratorio de MicroRNAs Unidad Académica de Ciencias Biológicas Universidad Autónoma de Zacatecas Zacatecas México

Ultraviolet radiation by its wavelength is divided into: UVA, UVB and UVC. Only UVA and UVB manage to penetrate the ozone layer, but due to anthropological activities, all of them are capable of interacting with humans to a greater or lesser extent, and can generate adverse effects such as cellular stress when interacting with intra-and extracellular biomolecules. The skin is the first organ in contact with UV radiation, and the stress it generates can be analyzed by the expression of a bioindicator of cellular damage such as Hsp70. Therefore, the objective of the project was: to determine the effect of UVA, UVB and UVC radiation on HaCaT epithelial cells, by analyzing the expression of Hsp70. Materials and methods: HaCaT cells were cultured in vitro, which were irradiated with UVA, UVB and UVC light at different doses, to subsequently determine the degree of Hsp70 expression by Immunodetection by PAGE-SDS and Western Blot. Results: Basal expression of Hsp70 was observed in no irradiated HaCaT cells. When HaCaT cells were irradiated with UVA, UVB, UVC, an increase in this Hsp70 protein was observed. With UVA, a higher degree of expression was observed at a time of 30 minutes of irradiation. With UVB the highest expression shifted to a time of 20 minutes. With UVC, overexpression was observed after 10 minutes. Conclusion: UV radiation generates cellular stress on HaCaT cells, evaluated by the stress bioindicator Hsp70. According to the wavelength of UV radiation, those that have a shorter wavelength have a greater potential for cellular damage, such as UVC.

关键词： Ultraviolet A Light (UVA) Ultraviolet B Light (UVB) Ultraviolet C Light (UVC) Heat Shock Protein 70 (Hsp70) HaCaT