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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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A comprehensive review of genetic causes of obesity

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World Journal of Pediatrics 2024年第1期20卷 26-39页

作者： marcio jose concepcion-zavaleta Juan Eduardo Quiroz-Aldave Maria del Carmen Durand-Vasquez Elman Rolando Gamarra-Osorio Juan del Carmen Valencia de la Cruz Claudia Mercedes Barrueto-Callirgos Susan Luciana Puelles-Leon Elena de Jesus Alvarado-Leon Frans Leiva-Cabrera Francisca Elena zavaleta-Gutierrez Luis Alberto concepcion-Urteaga jose Paz-Ibarra Universidad Cientifica del Sur Bolivar 2150 AvenuePueblo Libre15084LimaPeru Division of Medicine Hospital de Apoyo ChepénChepenPeru Division of Family Medicine Hospital de Apoyo ChepénChepenPeru Division of Endocrinology Hospital Victor Lazarte EchegarayTrujilloPeru Division of Pediatrics Hospital de Apoyo ChepenChepenPeru Division of Internal Medicine Hospital de Apoyo ChepenChepenPeru Division of Genetics Universidad Nacional de TrujilloTrujilloPeru Division of neonatology Hospital Belen de TrujilloTrujilloPeru Division of Internal Medicine Universidad Nacional de TrujilloTrujilloPeru Department of Medicine School of MedicineUniversidad Nacional Mayor de San MarcosLimaPeru

Background Obesity is a multifactorial chronic disease with a high,increasing worldwide *** causes account for 7%of the cases in children with extreme *** sources This narrative review was conducted by searching for papers published in the PubMed/MEDLInE,Embase and SciELO databases and included 161 *** search used the following search terms:"obesity","obesity and genetics","leptin","Prader-Willi syndrome",and"melanocortins".The types of studies included were systematic reviews,clinical trials,prospective cohort studies,cross-sectional and prospective studies,narrative reviews,and case *** The leptin-melanocortin pathway is primarily responsible for the regulation of appetite and body ***,several important aspects of the pathophysiology of obesity remain *** causes of obesity can be grouped into syndromic,monogenic,and polygenic causes and should be assessed in children with extreme obesity before the age of 5 years,hyperphagia,or a family history of extreme obesity.A microarray study,an analysis of the melanocortin type 4 receptor gene mutations and leptin levels should be performed for this *** are three therapeutic levels:lifestyle modifications,pharmacological treatment,and bariatric *** Genetic study technologies are in constant development;however,we are still far from having a personalized approach to genetic causes of obesity.A significant proportion of the affected individuals are associated with genetic causes;however,there are still barriers to its approach,as it continues to be underdiagnosed.

关键词： Leptin Melanocortin Obesity Prader-Willi syndrome Precision medicine

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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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Mechanical Complications after Myocardial Infarction: A Comprehensive Review

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World Journal of Cardiovascular Diseases 2024年第1期14卷 43-60页

作者： Alexis D. Aparicio-Ortiz María natalia Alonso-Jimenez Adrian Espejel-Guzman Aldo Cabello-Ganem Javier Serrano-Roman Santiago Luna-Alcala nilda Espinola-zavaleta Department of nuclear Cardiology National Institute of Cardiology Ignacio Chavez Mexico City Mexico Department of Echocardiography ABC Medical Center Mexico City Mexico

Mechanical complications of myocardial infarction are potentially fatal events that can occur after an acute myocardial infarction. While the introduction of primary percutaneous reperfusion and fibrinolysis has reduced the incidence of these complications to less than 1%. These complications pose significant hemodynamic consequences and necessitate prompt diagnosis. Echocardiography, cardiac magnetic resonance imaging, and computed tomography are valuable tools for establishing an accurate and expedited diagnosis. Consequently, it is imperative to conduct further scientific research to enhance hemodynamic stabilization techniques such as intra-aortic balloon counterpulsation and extracorporeal membrane oxygenation, in addition to exploring new surgical procedures that can reduce mortality resulting from mechanical complications. This article aims to provide a comprehensive review of mechanical complications following myocardial infarction and their correlation with multi-imaging, facilitating a better understanding of these complications.

关键词： Infarction Mechanical Complications Echocardiography Magnetic Resonance

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Fabry Disease: Update, Focusing on Heart Disease by Multimodal Imaging

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World Journal of Cardiovascular Diseases 2024年第6期14卷 351-362页

作者： Adrian Espejel-Guzman Emily Rodríguez Valente Fernandez-Badillo Javier Serrano-Roman Aldo Cabello-Ganem Alexis Daniel Aparicio-Ortiz Alberto Ramon-Rios Mariali Palacios-Cruz nilda Espinola-zavaleta Department of nuclear Cardiology. national Institute of Cardiology Ignacio Chavez Mexico City Mexico ABC Medical Center IAP Department of Echocardiography Mexico City Mexico

Fabry disease (FD) is a rare X-linked lysosomal accumulation disorder caused by a deficiency in the enzyme alpha-galactosidase A (Gal A), resulting in excessive storage of glycosphingolipids, particularly globotriaosylceramide (Gb3). This leads to cellular dysfunction in various organs, with cardiovascular compromise being the major cause of morbidity and mortality. This study aimed to provide a comprehensive overview of FD focusing on its genetic, epidemiological, clinical, diagnostic, and therapeutic aspects. This study explored the genetic mutations associated with FD, its epidemiology, clinical phenotypes, cardiac manifestations, diagnostic approaches, and current treatment options. Background: FD is caused by mutations in GLA on the X chromosome, with over 1000 identified variants. neonatal screening and specific studies have shown an increased incidence of FD. The clinical presentation varies between classic and late phenotypes, with cardiac involvement being a major concern, particularly in late-onset FD. Purpose: This study aimed to summarize the current knowledge on FD, emphasizing cardiac involvement, diagnostic modalities, and treatment options. Methods: A literature review of relevant studies on FD, including genetics, epidemiology, clinical presentation, diagnostic methods, and treatment options, was conducted. Results: Cardiac manifestations of FD included left ventricular hypertrophy (LVH), heart failure, arrhythmias, and sudden death. Diagnostic approaches such as electrocardiography, echocardiography, and cardiac magnetic resonance imaging play crucial roles in the early detection and monitoring of cardiac involvement. Enzyme replacement therapy (ERT) and emerging treatments have shown promise in managing FD, although challenges remain. Conclusions: FD remains a challenging condition in cardiology, with under-diagnosis being a concern. Early detection and specific therapy are essential to improve patient outcomes. Echocardiography and cardiac MRI ar

关键词： Fabry Disease Hypertrophic Cardiomyopathy Echocardiography Cardiac Magnetic Resonance Imaging Enzyme Replacement Therapy

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Diagnosis and management of small bowel neuroendocrine tumors:A state-of-the-art

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World Journal of Methodology 2022年第5期12卷 381-391页

作者： Jhean Gabriel Gonzáles-Yovera Pela J Roseboom marcio concepción-zavaleta Isamar Gutiérrez-Córdova Esteban Plasencia-Dueñas María Quispe-Flores Anthony Ramos-Yataco Carlos Alcalde-Loyola Frederick Massucco-Revoredo joséPaz-Ibarra Luis concepción-Urteaga Division of Gastroenterology María Auxiliadora HospitalLima 15801Peru Division of Emergency Medicine Regional Academic Hospital of TrujilloTrujillo 13011Peru Division of Endocrinology Stella Maris ClinicLima 15084Peru Division of Gastroenterology Guillermo Almenara Irigoyen National HospitalLima 12590Peru Division of Endocrinology Guillermo Almenara Irigoyen National HospitalLima 12590Peru Division of Internal Medicine Ricardo Cruzado Rivarola HospitalIca 110301Peru School of Medicine National University of TrujilloTrujillo 13007Peru Department of Medicine School of MedicineNational University of San MarcosLima 15001Peru Division of Internal Medicine School of MedicineNational University of TrujilloTrujillo 13011Peru

This review provides an update on the epidemiology,pathophysiology,symptoms,diagnosis and treatment of neuroendocrine neoplasms(nEns)of the small bowel(SB).These nEns are defined as a group of neoplasms deriving from neuroendocrine *** are currently the most common primary tumors of the SB,mainly involving the ileum,making the SB the most frequently affected part of the gastrointestinal *** nEns by definition are located between the ligament of Treitz and the ileocecal *** are characterized by small size and induce an extensive fibrotic reaction in the small intestine including the mesentery,resulting in narrowing or twisting of the *** manifestations of bowel functionality are related to the precise location of the primary *** majority of them are non-functional nEns and generally asymptomatic;in an advanced stage,nEns present symptoms of mass effect by non-specific abdominal pain or carcinoid syndrome which appears in patients with liver metastasis(around 10%).The main manifestations of the carcinoid syndrome are facial flushing(94%),diarrhea(78%),abdominal cramps(50%),heart valve disease(50%),telangiectasia(25%),wheezing(15%)and edema(19%).Diagnosis is made by imaging or biochemical tests,and the order of request will depend on the initial diagnostic hypothesis,while confirmation will always be *** patients with a localized SB nEn with or without near metastasis in the mesentery are recommended for curative *** and distant spread may be susceptible to several therapeutic strategies,such as chemotherapy,somatostatin analogs and palliative resection.

关键词： neuroendocrine Tumor Small bowel Small intestine Gastrointestinal disease Treatment Survival

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Population dynamics of three lizard species from the genus Sceloporus:short-term changes in demographic parameters

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Integrative Zoology 2019年第6期14卷 542-560页

作者： Selene VARGAS-GARCÍA Víctor ARGAEZ Israel SOLAnO-zavaleta J.Jaime ZÚÑIGA-VEGA Graduate Program in Biological Sciences National Autonomous University of MexicoUniversity CityMexico CityMéxico Department of Ecology and natural Resources Faculty of SciencesNational Autonomous University of MexicoUniversity CityMexico CityMéxico.

Most demographic studies focus on numerical changes that occur within populations across ***,typically studies at an interannual scale do not provide information on the particular times of the year(particular months or seasons)when rates of survival,recruitment,or migration increase or decrease due to physiological,behavioral or ecological *** monthly or seasonal changes in demographic parameters may lead to substantial variations in population *** this study,we collected capture-mark-recapture data on 3 species of lizards of the genus Sceloporus(Sceloporus torquatus,Sceloporus grammicus and Sceloporus megalepidurus)found in ecologically similar habitats to examine potential changes in demographic rates among 3 different climatic seasons:rainy,cold-dry and warm-dry *** tested different hypotheses about the effect of these seasons on survival,recruitment of new adults,and temporary *** found that during the season with severe thermal constraints,the cold-dry season,survival of *** decreased *** also detected a considerable increase in the recruitment rate of *** during the rainy season,when these lizards are establishing territories and finding *** contrast,we found no evidence of intra-annual changes in the rate of temporary *** addition,we calculated abundance and population growth rates for each species and for each *** study represents a significant contribution to the understanding of intra-annual demographic variation in lizards.

关键词： abundance recruitment Sceloporus lizards survival temporary emigration

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natural History of a Transitional Atrioventricular Septal Defect in an Adult Patient with Down Syndrome

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World Journal of Cardiovascular Diseases 2021年第7期11卷 342-346页

作者： Mara Escudero-Salamanca nilda Espinola-zavaleta nuclear Cardiology Department National Institute of Cardiology Ignacio Chavez Mexico City Mexico Mexican Faculty of Medicine La Salle University Mexico City Mexico Department of Echocardiography ABC Medical Center I.A.P Mexico City Mexico

Background: Atrioventricular septal defects (AVSD) are caused by a lack of development in atrioventricular endocardial cushions. Its spectrum varies from partial to transitional, or intermediate forms with a common A... 详细信息

n:justify;"> ng>Background: ng>Atrioventricular septal defects (AVSD) are caused by a lack of development in atrioventricular endocardial cushions. Its spectrum varies from partial to transitional, or intermediate forms with a common AV valve and 2 orifices, or even the complete form. Aim: The aim of this study is to present a case of a woman in the fifth decade of life with Down syndrome and a transitional AVSD, diagnosed with echocardiography. Case presentation: This is a patient in the fifth decade of life with Down syndrome, transitional AVSD, and severe pulmonary hypertension. Her vital signs were normal, oxygen saturation of 89% on room air. Auscultation revealed pronounced pulmonary component of the second heart sound, diastolic murmur in second left intercostal space, and moderate holosystolic heart murmur that radiated to axilla. The diagnosis was made with a transthoracic echocardiogram. The patient is receiving only medical treatment and since her last consult she has New York Heart Association (NYHA) functional class II. Conclusion: This case demonstrates the natural history of a patient in her fifth decade of life with down syndrome and complex congenital heart disease, despite having received only medical treatment, she is in functional class II. Echocardiography is the noninvasive technique of choice in the diagnosis and follow-up of patients with congenital heart diseases, as seen in this case.

关键词： Transitional Atrioventricular Septal Defect Pulmonary Hypertension Echocardiography

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Detection of dengue virus serotype 3 in Cajamarca,Peru:Molecular diagnosis and clinical characteristics

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Asian Pacific Journal of Tropical Medicine 2021年第10期14卷 456-462页

作者： Miguel Angel Aguilar-Luis Hugo Carrillo-ng Sungmin Kym Wilmer Silva-Caso Eduardo Verne Luis J.del Valle Jorge Bazán-Mayra Victor zavaleta-Gavidia Daniel Cornejo-Pacherres Yordi Tarazona-Castro Ronald Aquino-Ortega Angela Cornejo-Tapia Juana del Valle-Mendoza School of Medicine Research and Innovation Center of the Faculty of Health SciencesUniversidad Peruana de Ciencias AplicadasLimaPeru Laboratorio de Biologia Molecular Instituto de Investigación NutricionalLimaPeru Facultad de Medicina Alberto Hurtado Universidad Peruana Cayetano HerediaLimaPeru Division of Infectious Diseases Department of Internal MedicineChungnam National University School of MedicineDaejeonRepublic of Korea Barcelona Research Center for Multiscale Science and Engineering Departament d'Enginyeria QuímicaEEBEUniversitat Politècnica de Catalunya(UPC)BarcelonaSpain Laboratorio Regional de Cajamarca Dirección Regional de Salud de Cajamarca(DIRESA)CajamarcaPeru

Objective:To describe and molecularly characterize an outbreak of dengue virus(DEnV)infection in Cajamarca,an Andean region in ***:A total of 359 serum samples from patients with acute febrile illness were assessed for the presence of DEnV via RT-PCR,ELISA nS1,Ig M and Ig G in Cajamarca,Peru from January 2017 to June *** evaluation of the different diagnostic tests and their applicability was ***:Dengue virus was detected in 24.7%of samples by ***,serological analysis detected 30.3%positive cases via ELISA nS1 antigen,16.7%via ELISA Ig G and 9.7%via ELISA Ig *** of the cases corresponded to DEnV-3(77.5%).The use of RT-PCR performed better in primary infections(Pn of ELISA Ig M performed better in secondary infections(Pnation of nS1 and Ig M performed better than the other assays in detecting primary(92.5%)and secondary infections(96.6%).The most frequent symptoms associated with fever were headaches,myalgias,and arthralgias across all ***:We report an important outbreak of dengue infection caused by DEnV-3 in Cajamarca,*** findings encourage the use of nS1 antigen and Ig M *** findings demonstrate an increasing expansion of DEnV-3 in Peru and highlight the importance of molecular diagnosis and serotype characterization among the clinically defined dengue cases to strengthen the Peruvian epidemiological surveillance.

关键词： Dengue DEnV Arbovirus Diagnosis Peru

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Assessment of Papillary Fibroelastoma of the Semilunar Valves by Three-Dimensional Echocardiography

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World Journal of Cardiovascular Diseases 2017年第12期7卷 429-434页

作者： Leonel Avendano-Pérez nydia Avila-Vanzzini nilda Espinola-zavaleta Laboratory of non-Invasive Hemodynamics National Institute of Cardiology“Ignacio Chávez”TlalpanMexico Department of Out-Patients Clinic National Institute of Cardiology“Ignacio Chávez”TlalpanMexico

Papillary fibroelastoma is an uncommon tumor. Recognitions of this tumor have been improved thanks to modern imaging advances, which have made more patients to be identified, but at the same time, the management of this disease is still controversial. There aren’t enough studies to basic clinical actions. We present 2 interesting cases involving the semilunar valves. The purpose of presenting these cases is to review this rare disease and the superiority of the three-dimensional echocardiography in their diagnosis.

关键词： Heart Tumor Papillary Fibroelastoma Pulmonary Valve Aortic Valve Echocardiography

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