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Impact of an acute hemodynamic response-guided protocol for primary prophylaxis of variceal bleeding

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World Journal of Clinical Cases 2018年第13期6卷 611-623页

作者： José Ignacio Fortea ángela Puente Patricia Ruiz Iranzu Ezcurra Javier Vaquero Antonio Cuadrado maría teresa arias-loste Joaquín Cabezas Susana Llerena Paula Iruzubieta Carlos Rodríguez-Lope Patricia Huelin Fernando Casafont Emilio Fábrega Javier Crespo Servicio de Aparato Digestivo Hospital Universitario Marques? de Valdecilla Instituto de Investigación Sanitaria marqués de Valdecilla Centro de Investigación Biomédica Red de Enfermedades Hepáticas y Digestivas Laboratorio de Investigación en Hepatología y Gastroenterología Hospital General Universitario Gregorio Mara?ón-Instituto de Investigación Sanitaria Gregorio Mara?ón

AIM To evaluate the long-term outcome of an acute hemodynamic response-guided protocol in which acute responders to intravenous propranolol received traditional nonselective beta-blockers(NSBBs) and acute nonresponders received carvedilol.METHODS Retrospective review of a protocol for primary prophylaxis of variceal bleeding guided by the acute hemodynamic response to intravenous propranolol. Fifty-two acute responders treated with traditional NSBB(i.e. propranolol or nadolol) were compared with 24 acute nonresponders receiving carvedilol. A second hemodynamic study was performed in 27 and 13 patients, respectively. The primary endpoint was development of first or further decompensation. Secondary endpoints included death from any cause, association between acute and chronic hemodynamic response, and baseline clinical and laboratory variables related to the acute hemodynamic response.RESULTS Acute responders and acute nonresponders presented similar 1, 2, and 3-year probabilities of first decompensation(NSBB: 0%, 13.7%, 26.1% vs carvedilol: 0%, 20%, 20%, P = 0.968) or further decompensation(21.2%, 26.1%, 40.9% vs 21.2%, 50.0%, 50.0%, P = 0.525). A previous episode of hepatic encephalopathy was the only independent predictor of decompensation [hazard ratio(95% confidence interval): 8.03(2.76-23.37)]. Mortality rates were similar in acute responders and acute nonresponders with compensated(P = 0.428) or decompensated cirrhosis(P = 0.429). No clinical, laboratory, endoscopic or hemodynamic parameter predicted the acute hemodynamic response. In patients receiving traditional NSBB, the acute and chronic changes of hepatic venous pressure gradient were correlated(r = 0.59, P = 0.001). Up to 69.2% of acute nonresponders gained chronic response with carvedilol.CONCLUSION Early identification and treatment with carvedilol of acute nonresponders to intravenous propranolol improves the clinical outcome of this high-risk group of patients, probably due to its greater effects for reducing portal pressure.

关键词： Gastrointestinal hemorrhage Propranolol Carvedilol Liver cirrhosis Portal hypertension

Binge drinking: Burden of liver disease and beyond

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World Journal of Hepatology 2015年第27期7卷 2703-2715页

作者： Susana Llerena maría teresa arias-loste Angela Puente Joaquín Cabezas Javier Crespo Emilio Fábrega Gastroenterology and Hepatology Unit Marqués de Valdecilla University HospitalInstituto de Investigación Marqués de Valdecilla

The consumption of alcoholic beverages is harmful to human health. In recent years, consumption patterns of alcoholic beverages have changed in our society, and binge drinking has generalized. It is considered to be a socio-sanitary problem with few known consequences in terms of individual and third-party social impacts(in the form of violence or traffic accidents) and its organic impact(affects the liver and other organs and systems, such as the nervous and cardiovascular systems) and represents an important financial burden due to its increasing economic impact. This review provides a global approach to binge drinking and emphasizes its epidemiological character, the effect of this type of consumption and the possible management of a problem with an increasing tendency in our society.

关键词： Binge drinking Binge drinking adolescent Binge dri

On the effect of pitch and yaw angles in oblique impacts of smallcaliber projectiles

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Defence Technology（防务技术） 2024年第1期31卷 73-94页

作者： teresa Fras French-German Research Institute of Saint-Louis(ISL) Saint-LouisFrance

A terminal ballistic analysis of the effects of 7.62 mm × 51 AP P80 rounds on inclined high-strength armor steel plates is the focus of the presented study.The findings of an instrumented ballistic testing combined with 3D advanced numerical simulations performed using the IMPETUS Afea? software yielded the conclusions.The experimental verification proved that slight differences in the pitch-andyaw angles of a projectile upon an impact caused different damage types to the projectile’s core.The residual velocities predicted numerically were close to the experimental values and the calculated core deviations were in satisfactory agreement with the experimental results.An extended matrix of the core deviation angles with combinations of pitch-and-yaw upon impact angles was subsequently built on the basis of the numerical study.The presented experimental and numerical investigation examined thoroughly the influence of the initial pitch and yaw angles on the after-perforation projectile’s performance.

关键词： Ballistic impact Small-caliber projectile Pitch and yaw impact angles Shadowgraphy IMPETUS Afea Numerical simulations

Potential risk genes for primary Sjogren's syndrome from a meta-analysis by linear regression and random forest classification

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Genes & Diseases 2024年第3期11卷 128-131页

作者： Tomas Cerdo teresa Torres Moral Maimonides Biomedical Research Institute of Cordoba(IMIBIC) Reina Sofia University HospitalUniversity of CordobaCordoba 14004Spain Centre for Rheumatology Research Division of MedicineUniversity College LondonLondon W1T 4JFUK Faculty of Computer Sciences Multimedia and TelecommunicationUniversitat Oberta de CatalunyaBarcelona 08018Spain Dermatology Department Melanoma UnitAugust Pi i Sunyer Biomedical Research Institute(IDIBAPS)and Hospital ClinicBarcelona 08036Spain Center for Networked Biomedical Research on Rare Diseases(CIBERER) Carlos II Health InstituteMadrid 28029Spain

Primary Sjogren's syndrome(psS)is one of the most widespread autoimmune diseases with unknown origin,characterized by a lymphocytic infiltrate of the exocrine glands and the production of anti-SSA/Ro and anti-SSB/La antibodies that cause dysfunction and destruction mainly of salivary and lachrymal glands,leading to dry eyes and dry mouth.In the absence of a standardized evidence-based screening tool to decide which patients with dry eye must be referred for study of this pathology.

关键词： Sjogren lymphocytic salivary

Ductal carcinoma in situ within a fibroadenoma:A case report and review of literature

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World Journal of Radiology 2024年第3期16卷 58-68页

作者： Yazmin Olivares-Antúnez Yesika Janett Dávila-Zablah JoséRaúl Vázquez-Ávila Gabriela Sofía Gómez-Macías maría teresa Mireles-Aguilar margarita Lilia Garza-Montemayor Department of Diagnostic Breast Imaging Center Hospital Zambrano HellionTecnológico de MonterreyNuevo León 66260Mexico Department of Patology Service Hospital San JoséTecnológico de MonterreyNuevo León 64710Mexico Department of Faculty of Medicine Hospital Universitario de la UANLNuevo León 64710Mexico. Department of Breast Surgery Center Hospital Zambrano HellionTecnológico de MonterreyNuevo León 66260Mexico

BACKGROUND Fibroadenoma(FA)is the most common tumor found in young women,although it can occur in any age group.Ductal carcinoma in situ(DCIS)that is confined in a FA is rare;it is most frequently reported as an incidental finding.CASE SUMmarY We report a case of DCIS within a FA in a 46-year-old female without cancerrelated personal and family histories.The patient was diagnosed with a breast conglomerate of nodules and was followed for 1 year.In the current control image study,we found suspicious microcalcification,as a new finding,within one of the nodules.Consequently,a core biopsy of the tumor,which appeared hypoechoic,oval,and circumscribed,was performed.The pathological diagnosis was ductal carcinoma in situ within a fibroepithelial lesion.The patient underwent breastconserving surgery and received radiotherapy as well as endocrine therapy(tamoxifen).CONCLUSION We recommend a multidisciplinary approach for adequate treatment and followup.

关键词： Carcinoma in situ Fibroadenoma Mammography Ultrasound Magnetic resonance imaging Radiology Case report

A Comparison between Late Preterm and Term Infants with Respiratory Distress Syndrome, Early-Onset Sepsis, and Neonatal Jaundice in Ecuadorian Newborns

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Open Journal of Pediatrics 2024年第1期14卷 22-35页

作者： teresa Altamirano Molina Colegio Ciencias de la Salud Universidad San Francisco de Quito USFQ calle Diego de Robles s/n y Pampite Quito Ecuador Servicio de Neonatología Hospital General del Sur de Quito calle Moraspungo s/n y Pinllopata Quito Ecuador

Background: To examine the differences in prevalence of respiratory distress syndrome, early-onset sepsis and jaundice, between late preterm infants versus term infants in Ecuadorian newborns. Methods: Study design: Epidemiological, observational, and cross-sectional, with two cohorts of patients. Settings: IESS Quito Sur Hospital at Quito, Ecuador, from February to April of 2020. Participants: This study included 204 newborns, 102 preterm infants, 102 term infants. Results: There are significant differences between late preterm infants and term infants, with a p-value of 0.000 in the prevalence of early sepsis, 70.59% vs. 35.29%. In respiratory distress syndrome between late and term premature infants, significant differences were observed with a p-value of 0.000, the proportion being 55.58% vs. 24.51% respectively. The prevalence of jaundice is higher in term infants with a p value of 0.002, 72.55%, versus 51.96% in late preterm infants, and the mean value of bilirubins in mg/dL was higher in term infants 14.32 versus 12.33 in late preterm infants;this difference is statistically significant with a p value of 0.004. Admission to the NICU is more frequent in late preterm infants with a p-value of 0.000, being 42.16% for late preterm infants vs. 7.84% in term infants;the mean of the hospital days with p-value 0.005, was higher in late preterm infants 4.97 days vs. 3.55 days for term newborns. Conclusion: Due to the conditions of their immaturity, late preterm infants are 2.86 times more likely to present early sepsis than full-term newborns. It is shown that late preterm infants are 2.69 times more likely to have respiratory distress syndrome compared to term infants, therefore, late preterm infants have a longer hospital stay of 4.97 days versus 3.55 days in term infants. Jaundice and mean bilirubin levels are higher in term infants due to blood group incompatibility and insufficient breastfeeding.

关键词： Late Preterm Term Newborn Respiratory Distress Syndrome Early Onset Sepsis Jaundice

Integration of Environmental and Social Values in Cultural Spaces:Sustainable and Inclusive Wayfinding Materials for Museums

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Journal of Civil Engineering and Architecture 2024年第5期18卷 207-217页

作者： Cristiana Cellucci teresa Villani Department of Architecture and Arts IUAV University of VeniceVenice 219630123Italy Department of Planning Designand TechnologyFaculty of ArchitectureSapienza University of RomeRome 00185Italy

In the context of use of large museum centers,numerous national and international methodological experiments show that the wayfinding project must consider the needs of both habitual users(user-centered design)and local communities(design for communities)and the importance of environmental protection(eco-design)as a priority interest of the community.This“double target”,“user-centered”and“environment-centered”can be applied during the selection process of materials to be used in the project.With respect to these possibilities,this contribution intends to present the results of research focused on material characterization of the reception and distribution spaces of large museum centers.This characterization is based on use of sensory materials and aims to evaluate their impact on the usability and sustainability of wayfinding systems.The paper directed towards a proposal for organization of integrated information on new generation so-called smart materials;within the design of a wayfinding system,these can balance the aesthetic-perceptual and performance and environmental impact,in order to allow designers to make informed decisions oriented towards inclusion and sustainability.The study was addressed by conducting two phases of systematic literature and library review of materials.The investigations conducted led to achievement of a first research result which consists in the identification of a“standard sheet”for the mapping and cataloging of the materials used for wayfinding.The“standard sheet”allows organizing the information on smart,sensorial,and eco-friendly materials,balancing the aesthetic-perceptive component with the performance on the environmental impact along the entire life cycle in a circular perspective.This tool could guide designers towards an environmental communication project oriented towards sustainability and is effective for usability and wayfinding.

关键词： Wayfinding eco-friendly materials sensory materials user-centered design eco-design innovative museum

Lack of evidence for germline WWP1 pathogenic variants in gastrointestinal polyposis and other phenotypes suggestive of PTEN-hamartoma-tumor syndrome

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Genes & Diseases 2024年第2期11卷 524-527页

作者： Noemi Gonzalez-Abuin Tirso Pons teresa Fuster Isabel Quintana mariona Terradas Gemma Aiza Joan Brunet Gabriel Capellá Heather Hampel Laura Valle Hereditary Cancer Program Catalan Institute of OncologyOncobell ProgramIDIBELLHospitalet de LlobregatBarcelona 08908Spain Department of Immunology and Oncology National Center for BiotechnologySpanish National Research Council (CNB-CSIC)Madrid 28049Spain Centro de Investigación Biomédica en Red de Cáncer (CIBERONC) Madrid 28029Spain Catalan Institute of Oncology IDIBGiGirona 17007Spain Division of Clinical Cancer Genomics Department of Medical Oncology & Therapeutic ResearchCity of Hope National Cancer CenterDuarteCA 91010USA

Germline activating variants in WWP1,which encodes an E3 ubiquitin ligase that antagonizes PTEN tumor suppressive function,have been proposed as an alternative mechanism of PTEN inactivation in PTEN-hamartoma-tumor syndrome(PHTS)-like patients with wildtype PTEN.1 More specifically,heterozygous,potentially activating wwP1 variants were first identified by Lee et al in patients affected with gastrointestinal oligopolyposis,including adenomatous,hyperplastic/serrated,and hamartomatous polyps,and occasionally with colorectal cancer(Table 1).Subsequently,based on the PHTS phenotypic features,wWP1 mutational screening was performed in patients with thyroid nodules,2 or normocephalic autism spectrum disorder(ASD),3 where germline WWP1 variants were also identified(Table S1).

关键词： WWP1 gastrointestinal polyposis

On the Range of Action of Adult Culex pipiens s.l.

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Journal of Biosciences and Medicines 2024年第3期12卷 113-121页

作者： maria da Conceição Proença maria teresa Rebelo Department of Physics and marE-ULisboa Marine and Environmental Sciences Centre & ARNET Aquatic Research Infrastructure Network Associated Laboratory Faculty of Sciences University of Lisbon Lisbon Portugal Department of Animal Biology and CESAM_Ciências Centre for Environmental and Marine Studies Faculty of Sciences University of Lisbon Lisbon Portugal

Mosquitoes are an interesting topic due to their medical importance, as they play an active role in the transmission of many pathogens and parasites, acting as vectors for various pathologies that are deadly to humans, such as dengue, yellow fever, chikungunya, West Nile virus, encephalitis and malaria, among many others that are less common. In terms of morbidity and mortality caused by vector-borne diseases, mosquitoes are the most dangerous animals for humanity and, although they also play a role in the ecosystem as a food source for other organisms, their importance for public health cannot be overlooked. As highly efficient vectors, they put more than three billion people at risk, mainly in tropical and subtropical regions as well as in Europe, since heat waves and flooding are becoming more frequent and severe, and summers are getting longer and warmer, accelerating mosquito development, biting rates, and the incubation of the pathogens within their bodies. Female mosquitoes bite to acquire proteins for the development of their ovaries and eggs and, in the process, acquire pathogens and/or parasites from one vertebrate host and transmit them to another, usually after a short period of replication. Three of their four life stages are lived in still freshwater, so it is crucial to understand their range of action when they reach adulthood and leave the water, in order to plan and implement local prevention measures. A set of georeferenced abundance data collected in mainland Portugal over seven years was linked to cartographed water bodies in a geographic information system to estimate the distances at which Culex pipiens s.l. had a significant presence, with criteria based on the size of the catches. The result allows for an estimate of the fly range of those mosquitoes, which can be used to focus countermeasures.

关键词： Mosquito Fly Distance Vector-Borne Diseases Culex pipiens s.l. Geographic Information Systems