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Clinical usefulness of adherence to gastro-esophageal reflux disease guideline by Spanish gastroenterologists

World Journal of Gastroenterology 2012年第35期18卷 4885-4891页

作者： Fermín Mearin Julio ponce marta ponce Agustín Balboa Miguel A González Javier Zapardiel Service of Gastroenterology Centro Medico Teknon Digestive Disease Unit Hospital Quiron Centro de Investigacion Biomedica en Red:Enfermedades Hepaticasy Digestivas Service of Gastroenterology Hospital Universitario La Fe Biostatistics Innovex-Grupo Quintiles Espana Medical Department AstraZeneca Farmaceutica

AIM:To investigate usefulness of adherence to gastroesophageal reflux disease(GERD) guideline established by the Spanish Association of ***:Prospective,observational and multicentre study of 301 patients with typical symptoms of GERD who should be managed in accordance with guidelines and were attended by gastroenterologists in daily ***(aged > 18 years) were eligible for inclusion if they had typical symptoms of GERD(heartburn and/or acid regurgitation) as the major complaint in the presence or absence of accompanying atypical symptoms,such as dyspeptic symptoms and/or supraesophageal *** and therapeutic decisions should be made based on specific recommendations of the Spanish clinical practice guideline for GERD which is a widely disseminated and well known instrument among Spanish in digestive disease ***:Endoscopy was indicated in 123(41%) patients:50 with alarm symptoms,32 with age > 50 years without alarm ***-two patients(58.5%) had esophagitis(grade A,23,grade B,28,grade C,18,grade D,3).In the presence of alarm symptoms,endoscopy was indicated consistently with recommendations in 98% of ***,in the absence of alarm symptoms,endoscopy was indicated in 33% of patients > 50 years(not recommended by the guideline).Adherence for proton pump inhibitors(PPIs) therapy was 80%,but doses prescribed were lower(half) in 5% of cases and higher(double) in 15%.Adherence regarding duration of PPI therapy was 69%;duration was shorter than recommended in 1%(4 wk in esophagitis grades C-D) or longer in 30%(8 wk in esophagitis grades A-B or in patients without endoscopy).Treatment response was higher when PPI doses were consistent with guidelines,although differences were not significant(95% vs 85%).CONCLUSION:GERD guideline compliance was quite good although endoscopy was over indicated in patients > 50 years without alarm symptoms;PPIs were prescribed at higher doses and longer duration.

关键词： Gastro-esophageal reflux disease Clinicalpractice guidelines Adherence to guidelines Treatmentof gastro-esophageal reflux disease

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Non-guided self-learning program for high-proficiency optical diagnosis of diminutive and small colorectal lesions: A single-endoscopist pilot study

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World Journal of Gastroenterology 2019年第10期25卷 1278-1287页

作者： Marco Bustamante-Balén Carla Satorres Lorena Puchades Belén Navarro Natalia García-Morales Noelia Alonso marta ponce Lidia Argüello Vicente Pons-Beltrán Gastrointestinal Endoscopy Research Group Gastrointestinal Endoscopy UnitDigestive Diseases DepartmentLa Fe Polytechnic University Hospital Digestive Diseases Department La Fe Polytechnic University Hospital Gastrointestinal Endoscopy Unit Digestive Diseases DepartmentLa Fe Polytechnic University Hospital

BACKGROUND The implementation of optical diagnosis(OD) of diminutive colorectal lesions in clinical practice has been hampered by differences in performance between community and academic settings. One possible cause is the lack of a standardized learning tool. Since the factors related to better learning are not well described, strong evidence upon which a consistent learning tool could be designed is lacking. We hypothesized that a self-designed learning program may be enough to achieve competency in OD of diminutive lesions of the *** To assess the accuracy of OD of diminutive lesions in real colonoscopies after application of a self-administered learning *** This was a single-endoscopist prospective pilot study, in which an experienced endoscopist followed a self-designed, self-administered learning program in OD of colorectal lesions. An assessment phase divided in two halves with a 6-mo period in between without performance of OD was developed in a populationbased colorectal cancer screening program. The accomplishment of the Preservation and Incorporation of Valuable Endoscopic Innovations criteria and performance measures were calculated overall and in the two halves of the assessment phase, assessing their response to the 6-mo stopping period. The evolution of performance through blocks of 50 lesions was also *** Overall, 152 patients and 522 lesions(≤ 5 mm: 399, and 6-9 mm: 123) were included. The negative predictive value for the OD of adenoma in rectosigmoid lesions diagnosed with high confidence was 91.7% [95% confidence interval(CI):87.3-96.6]. The proportion of agreement on surveillance interval between OD and pathological diagnosis was higher than 95%. Overall accuracy for diminutive lesions diagnosed with high confidence was 89.5%(95%CI: 86.3-92.7). The overall accuracy of OD was similar in the two halves of the assessment phase [90.1(95%CI: 85.6-94.7) vs 88.2(95%CI: 87.9-95.9)]. All the other performance parameters we

关键词： Optical diagnosis Accuracy Learning Polyp Colonoscopy Education

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Prognosis and follow-up of 135 patients with ischemic colitis over a five-year period

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World Journal of Gastroenterology 2013年第44期19卷 8042-8046页

作者： Angel Cosme Miguel Montoro Santos Santolaria Ana B Sanchez-Puertolas marta ponce Margarita Durán Jose Luis Cabriada Nerea Borda Cristina Sarasqueta Luis Bujanda Department of Gastroenterology Hospital de Donostia-Instituto BiodonostiaCentro de Investigaciones Biomédicas en Red en Enfermedades Hepáticas y Digestivas (CIBERehd) Universidad del País Vasco UPV/EHU 20014 San Sebastián Spain Department of Gastroenterology Hospital San Jorge22004 Huesca Spain Department of Gastroenterology Hospital Universitari La Fé 46026 Valencia Spain Department of Gastroenterology Hospital de Galdakao 48960 Bizcaia Spain Institute Biodonostia CIBEResp 20014 San Sebastián Spain

AIM:To study the prognosis(recurrence and mortality)of patients with ischemic colitis(IC).METHODS:This study was conducted in four Spanish hospitals,participants in the Ischemic Colitis in Spain study We analyzed prospectively 135 consecutive patients who met criteria for definitive or probable IC according to Brandt criteria,and follow up these patients during the next five years,***-term results(recurrence and mortality)were evaluated retrospectively after a median interval of 62 mo(range54-75 mo).RESULTS:Estimated IC recurrence rates were 2.9%,5.1%,8.1%and 9.7%at years 1,2,3 and 5 years,***-year survival was 69%(93 of 135)and 24%(10 of 42 patients)died for causes related to the *** these 10 patients,8 died in their first episode at hospital(4 had gangrenous colitis and 4 fulminant colitis)and 2 due to ***:The five-year recurrence rate of IC was *** the other hand,mortality during follow-up was high and was not associated with ischemic colitis.

关键词： Colonic Ischemic Recurrence Follow-up Mortality

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The animal cachexia score(ACASCO)

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Animal Models and Experimental Medicine 2019年第3期2卷 201-209页

作者： Angelica Betancourt Sílvia Busquets marta ponce Míriam Toledo Joan Guàrdia‐Olmos Maribel Peró‐Cebollero Francisco J.López‐Soriano Josep M.Argilés Cancer Research Group Departament de Bioquímica i Biomedicina MolecularFacultat de BiologiaUniversitat de BarcelonaBarcelonaSpain Institut de Biomedicina de la Universitat de Barcelona BarcelonaSpain Advanced Statistical Data Analysis Applied to Psychology Departament de Metodologia de les Ciències del ComportamentFacultat de PsicologiaUniversitat de BarcelonaBarcelonaSpain Institut de recerca en Cervell Cogniciói Conducta(IR3C)BarcelonaSpain

Background:None of the published studies involving cancer cachexia experimental models have included a measure of the severity of the syndrome like the scoring system previously developed for human *** aim of the present investigation was to define and validate a cachexia score usable in both rat and mouse tumor ***:In order to achieve this goal,we included in the study one rat model(Yoshida AH‐130ascites hepatoma)and two mouse models(Lewis lung carcinoma and Colon26 carcinoma).The Animal cachexia score(ACASCO)includes five components:(a)body and muscle weight loss,(b)inflammation and metabolic disturbances,(c)physical performance,(d)anorexia,and(e)quality of life measured using discomfort symptoms and behavioral ***:Using the ACASCO values,three cut‐off values were estimated by applying hierarchical cluster *** groups were originally described,one exactly below the observed mean,a second exactly over the mean,and two other groups adjusted to every cue(inferior and superior).The three cut‐off values were estimated through maximization of the classification *** was accomplished by using a similarity matrix based on the metric properties of the variables and assuming multinormal *** results show that the four groups were:no cachexia,mild cachexia,moderate cachexia and advanced ***:The results obtained allow us to conclude that the score could be very useful as an endpoint in pre‐clinical studies involving therapeutic strategies for cancer *** potential usefulness of ACASCO relates to the primary endpoint in pre‐clinical cancer cachexia drug evaluations.

关键词： anorexia cachexia classification physical performance quality of life score wasting weight loss

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Management of betablocked patients after sustained virological response in hepatitis C cirrhosis

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World Journal of Gastroenterology 2019年第21期25卷 2665-2674页

作者： marta Abadía María Luisa Montes Dolores ponce Consuelo Froilán Miriam Romero Joaquín Poza Teresa Hernández Rubén Fernández-Martos Antonio Olveira Antonio Olveira Servicio de Aparato DigestivoHospital Universitario La PazMadrid 28046Spain Unidad VIH Servicio de Medicina InternaHospital Universitario La PazMadrid 28046Spain Servicio de Radiología Hospital Universitario La PazMadrid 28046Spain CIBERehd IdiPAZ Madrid 28029Spain

BACKGROUND Current guidelines do not address the post–sustained virological response management of patients with baseline hepatitis C virus (HCV) cirrhosis and oesophageal varices taking betablockers as primary or secondary prophylaxis of variceal bleeding. We hypothesized that in some of these patients portal hypertension drops below the bleeding threshold after sustained virological response, making definitive discontinuation of the betablockers a safe option. AIM To assess the evolution of portal hypertension, associated factors, non-invasive assessment, and risk of stopping betablockers in this population. METHODS Inclusion criteria were age > 18 years, HCV cirrhosis (diagnosed by liver biopsy or transient elastography > 14 kPa), sustained virological response after directacting antivirals, and baseline oesophageal varices under stable, long-term treatment with betablockers as primary or secondary bleeding prophylaxis. Main exclusion criteria were prehepatic portal hypertension, isolated gastric varices, and concomitant liver disease. Blood tests, transient elastography, and upper gastrointestinal endoscopy were performed. Hepatic venous pressure gradient (HVPG) was measured five days after stopping betablockers. Betablockers could be stopped permanently if gradient was < 12 mmHg, at the discretion of the attending physician. RESULTS Sample comprised 33 patients under treatment with propranolol or carvedilol: median age 64 years, men 54.5%, median Model for End-Stage Liver Disease (MELD) score 9, Child-Pugh score A 77%, median platelets 77.000 × 103/μL, median albumin 3.9 g/dL, median baseline transient elastography 24.8 kPa, 88% of patients received primary prophylaxis. Median time from end of antivirals to gradient was 67 wk. Venous pressure gradient was < 12 mmHg in 13 patients (39.4%). In univariate analysis the only associated factor was a MELD score decrease from baseline. On endoscopy, variceal size regressed in 19/27 patients (70%), although gradient was

关键词： Hepatitis C virus Oesophageal varices Portal hypertension Betablocker Variceal bleeding

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Clinical-pathological and molecular characterization of long-term survivors with advanced non-small cell lung cancer

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Cancer Biology & Medicine 2020年第2期17卷 444-457页

作者： Juan Moreno-Rubio Santiago ponce Rosa Alvarez Maria Eugenia Olmedo Sandra Falagan Xabier Mielgo Fatima Navarro Patricia Cruz Luis Cabezon-Gutierrez Carlos Aguado Gonzalo Colmenarejo marta Munoz-Fernandez de Leglaria Ana Belen Enguita Maria Cebollero Amparo Benito Isabel Alemany Carolina del Castillo Ricardo Ramos Ana Ramirez de Molina Enrique Casado Maria Sereno Ana Ramirez de Molina1 Enrique Casado5Maria Sereno5 XIMDEA Food InstituteCEI UAM+CSICMadrid 28702Spain 12 de Octubre University Hospital Madrid 28041Spain Gregorio Maranon University Hospital Madrid 28009Spain Ramon y Cajal University Hospital Madrid 28034Spain Infanta Sofia University Hospital San Sebastian De Los ReyesMadrid 28702Spain Fundacion Alcorcon University Hospital AlcorconMadrid 28922Spain Prlncipe de Asturias University Hospital Alcala De HenaresMadrid 28805Spain La Paz University Hospital Madrid 28046Spain University Hospital of Torrejon Torrejon De ArdozMadrid 28850Spain Clinico San Carlos University Hospital Madrid 28040Spain Parque Cientifico de Madrid Foundation Madrid 28049Spain

Objective:Long-term survivors(LS)of non-small cell lung cancer(NSCLC)without driver alterations,displaying an overall survival(OS)of more than 3 years,comprise around 10%of cases in several series treated with *** are classical prognosis factors for these cases[stage,Eastern Cooperative Oncology Group(ECOG),etc.],but more data are required in the *** this multi-center study,we focused on LS of advanced NSCLC with OS above 36 months to perform a clinical-pathological and molecular ***:In the first step,we conducted a clinical-pathological characterization of the ***,we carried out a genetic analysis by comparing LS to a sample of short-term survivors(SS)(with an OS less than 9 months).We initially used whole-genome RNA-seq to identify differentiating profiles of LS and SS,and later confirmed these with reverse transcription-polymerase chain reaction(RT-PCR)for the rest of the ***:A total of 94 patients were included,who were mainly men,former smokers,having adenocarcinoma(AC)-type NSCLC with an ECOG of *** obtained an initial differential transcriptome expression,displaying 5 over-and 33 under-expressed genes involved in different pathways:namely,the secretin receptor,surfactant protein,trefoil factor 1(T FF1),serpin,Ca-channels,and Tolllike receptor(TLRs)***,RT-PCR analysis of 40(20 LS/20 SS)samples confirmed that four genes(surfactant proteins and SFTP)were significantly down-regulated in SS compared to LS by using an analysis of covariance(ANCOVA)model:SFTPA1(P=0.023),SFTPA2(P=0.027),SFTPB{P=0.02),and SFT PC(P=0.047).Conclusions:We present a sequential genetic analysis of a sample of NSCLCLS with no driver alterations,obtaining a differential RNA-seq/RT-PCR profile showing an abnormal expression of SF genes.

关键词： Long-term survivors non-small cell lung cancer surfactant proteins

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