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Management of recurrent hepatitis C virus after liver transplantation

World Journal of Gastroenterology 2014年第44期20卷 16409-16417页

作者： miguel jiménez-pérez Rocío González-Grande Francisco Javier Rando-Mu?oz Liver transplantation and hepatology unit UGC de Aparato Digestivo Hospital Regional Universitario Department of Abdominal Diseases Hospital Nij Smellinghe Ziekenhuis

Chronic hepatitis C virus (HCV) infection is the leading cause of death from liver disease and the leading indication for liver transplantation (LT) in the United States and Western Europe. LT represents the best therapeutic alternative for patients with advanced chronic liver disease caused by HCV or those who develop hepatocarcinoma. Reinfection by HCV of the graft is universal and occurs in 95% of transplant patients. This reinfection can compromise graft function and patient survival. In a few cases, the histological recurrence is minimal and non-progressive; however, in most patients it follows a more rapid course than in immunocompetent persons, and frequently evolves into cirrhosis with graft loss. In fact, the five-year and ten-year survival of patients transplanted because of HCV are 75% and 68%, respectively, compared with 85% and 78% in patients transplanted for other reasons. There is also a pattern of recurrence that is very severe, but rare (patitis, which often involves rapid graft loss. patients who present a negative HCV viremia after antiviral treatment have better survival. Many studies published over recent years have shown that antiviral treatment of post-transplant HCV hepatitis carried out during the late phase is the best option for improving the prognosis of these patients. Until 2011, pEGylated interferon plus ribavirin was the standard of care, resulting in a sustained virological response in around 30% of recipients. The addition of protease inhibitors, such as boceprevir or telaprevir, to the standard of care, or the use of other direct-acting antiviral drugs may involve therapeutic changes in the context of HCV recurrence. This may result a better prognosis for these patients, particularly those with severe recurrence or factors predicting rapid progression of fibrosis. However, the use of these agents in LT still requires clarification in terms of safety and efficacy.

关键词： Hepatitis C virus Liver transplantation Recurrence Treatment

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present and future management of viral hepatitis

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World Journal of Gastroenterology 2021年第47期27卷 8081-8102页

作者： Rocío González Grande Inmaculada Santaella Leiva Susana López Ortega miguel jiménez pérez UGC de Aparato Digestivo.Unidad de Hepatología-Trasplante Hepático Hospital Regional Universitario de MálagaMálaga 29010Spain

Viral hepatitis can result in important morbidity and mortality,with its impact on health conditioned by the specific type of hepatitis,the geographical region of presentation and the development and access to new drugs,among other *** acute presentation forms are self-limiting and may even go unnoticed,with just a small percentage of cases leading to acute liver failure that may necessitate transplantation or even cause the death of the ***,when they become chronic,as in the case of hepatitis B virus and C virus,unless they are diagnosed and treated adequately they may have severe consequences,like cirrhosis or *** of the mechanisms of transmission,the pathogenesis,the presence of vaccinations and the development over recent years of new highly-efficient,potent drugs have meant that we are now faced with a new scenario in the management of viral hepatitis,particularly hepatitis B virus and hepatitis C *** spectacular advances in hepatitis C virus treatment have led the World Health Organization to propose the objective of its eradication by *** key aspect to achieving this goal is to ensure that these treatments reach all the more vulnerable population groups,in whom the different types of viral hepatitis have a high prevalence and constitute a niche that may perpetuate infection and hinder its ***,microelimination programs assume special relevance at the present time.

关键词： Hepatitis viral Diagnosis Treatment Trend direct-acting antivirals Inhibiting recycling

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Metabolic complications in liver transplant recipients

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World Journal of Gastroenterology 2016年第28期22卷 6416-6423页

作者： miguel jiménez-pérez Rocío González-Grande Edith Omonte Guzmán Víctor Amo Trillo Juan miguel Rodrigo López UGC de Aparato Digestivo Unidad de Hepatología-Trasplante Hepático Hospital Universitario Regional de Málaga

The metabolic syndrome(MS), which includes obesity,dyslipidaemia, hypertension and hyperglycaemia according to the most widely accepted definitions now used, is one of the most common post-transplant complications, with a prevalence of 44%-58%. The MS, together with the immunosuppression, is considered the main risk factor for the development of cardiovascular disease(CVD) in transplant recipients, which in turn accounts for 19%-42% of all deaths unrelated to the graft. The presence of MS represents a relative risk for the development of CVD and death of 1.78. On the other hand, non-alcoholic fatty liver disease(NAFLD), considered as the manifestation of the MS in the liver, is now the second leading reason for liver transplantation in the United States after hepatitis C and alcohol. NAFLD has a high rate of recurrence in the liver graft and a direct relation with the worsening of other metabolic disorders, such as insulin resistance or diabetes mellitus. Consequently, it is vitally important to identify and treat as soon as possible such modifiable factors as hypertension, overweight, hyperlipidaemia or diabetes in transplanted patients to thus minimise the impact on patient survival. Additionally, steroid-free regimens are favoured, with minimal immunosuppression to limit the possible effects on the development of the MS.

关键词： Metabolic syndrome Liver transplantation Immunosuppressions Risk factors Non-alcoholic fatty liver disease

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Ca-based materials derived from calcined cigarette butts for CO_(2)capture and thermochemical energy storage

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Journal of Environmental Sciences 2024年第6期140卷 230-241页

作者： Nabil Amghar Virginia Moreno pedro E.Sánchez-jiménez Antonio perejón Luis A.pérez-Maqueda Instituto de Ciencia de Materiales de Sevilla C.S.I.C.-Universidad de SevillaC.Américo Vespucio4941092 SevillaSpain Instituto de Tecnología de Materiales(ITM) Universitat Politècnica de València(UPV)Plaza Ferrándiz y Carbonell 1AlcoyAlicante 03801Spain Departamento de Química Inorgánica Facultad de QuímicaUniversidad de Sevilla41012 SevillaSpain

Cigarette butts(CBs)are one of the most common types of litter in the *** to the toxic substances they contain,the waste generated poses a harmful risk to the environment,and therefore there is an urgent need for alternative solutions to landfill ***,this work presents a possible revalorization of this waste material,which implies interesting environmental *** were used as sacrificial templates for the preparation of CaO-based materials by impregnation with calcium and magnesium nitrates followed by flaming *** materials presented enhanced porosity for their use in the Calcium Looping process applied either to thermochemical energy storage or CO_(2)capture *** influence of the concentration of Ca and Mg in the impregnating solutions on the multicycle reactivity of the samples was *** improved multicycle performance was obtained in terms of conversion for both applications.

关键词： Cigarette butts Calcium-Looping CO_(2)Capture Thermochemical energy storage

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New approaches in the treatment of hepatitis C

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World Journal of Gastroenterology 2016年第4期22卷 1421-1432页

作者： rocío gonzález-grande miguel jiménez-pérez carolina gonzález arjona josémostazo torres Liver Transplantation and Hepatology Unit UGC de Aparato DigestivoHospital Regional Universitario29010 MalagaSpain

About 130-170 million people, is estimated to be infected with the hepatitis C virus(HCV). Chronic HCV infection is one of the leading causes of liverrelated death and in many countries it is the primaryreason for having a liver transplant. The main aim of antiviral treatment is to eradicate the virus. Until a few years ago the only treatment strategy was based on the combination of pegylated interferon and ribavirin(pEG/RBV). However, in genotypes 1 and 4 the rates of viral response did not surpass 50%, reaching up to 80% in the rest. In 2011 approval was given for the first direct acting antiviral agents(DAA), boceprevir and telaprevir, for treatment of genotype 1, in combination with traditional dual therapy. This strategy managed to increase the rates of sustained viral response(SVR) in both naive patients and in retreated patients, but with greater toxicity, interactions and cost, as well as being less safe in patients with advanced disease, in whom this treatment can trigger decompensation or even death. The recent, accelerated incorporation since 2013 of new more effective DAA, with pan-genomic properties and excellent tolerance, besides increasing the rates of SVR(even up to 100%), has also created a new scenario: shorter therapies, less toxicity and regimens free of pEG/RBV. This has enabled their almost generalised applicability in all patients. However, it should be noted that most of the scientific evidence available is based on expert opinion, case-control series, cohort studies and phase 2 and 3 trials, some with a reduced number of patients and select groups. Few data are currently available about the use of these drugs in daily clinical practice, particularly in relation to the appearance of side effects and interactions with other drugs, or their use in special populations or persons with the less common genotypes. This situation suggests the need for the generalised implementation of registries of patients receiving antiviral therapy. The main inco

关键词： Hepatitis C Treatment Direct acting antiviralagents patients Outcome

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Reuse of port industrial heritage in tourist cities:Shipyards as case studies

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Frontiers of Architectural Research 2024年第1期13卷 164-183页

作者： María J.Andrade Eduardo jiménez-Morales Rachel Rodríguez-Ramos pablo Martínez-Ramírez Department of Art and Architecture School of ArchitectureMalaga UniversityMalaga 29013Spain

The progressive deindustrialisation of many western cities since the 1980s has led to many industrial zones linked to port activities being abandoned or falling into *** such as Barcelona,Naples,Lisbon,Amsterdam,and Hamburg have port industrial complexes of high tangible and intangible heritage value that could totally or partially disappear,resulting in an irreparable loss of their scientific,architectural,social,technological,and historical *** that in mind,Adaptive Reuse(AR)of the built heritage allows the industrial memory of the ports to be preserved by turning them into new functional centres within the existing urban *** occurs in the context of the contemporary challenges of those cities,such as touristification,the circular economy and climate change,while guaranteeing the life cycle of those *** article analyses two case studies—the Nederlandsche Scheepsbouw Maatschappij(NDSM)and the Rotterdamsche Droogdok Maatschappij(RDM)shipyards,both in the Netherlands—in order to contribute to the knowledge of AR of port Industrial *** are two examples of good practices in port industrial heritage interventions,where the factors behind their acclaim can be easily highlighted.A multi-scale methodology is therefore used and tailored to the case of port industrial heritage,based on analysing previous studies of the heritage in different spheres and on different scales.A relationship matrix tool is thus *** enables a comparative study to be conducted,using key variables and indicators,and considering qualitative and quantitative *** provides extensive output information for each case study,which is summarised in the most favourable factors for the success of the AR of this port industrial heritage.

关键词： Industrial heritage port-city Adaptive reuse Best practices Circular economy HUL Touristification

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Management of hepatitis B virus infection after liver transplantation

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World Journal of Gastroenterology 2015年第42期21卷 12083-12090页

作者： miguel jiménez-pérez Rocío González-Grande José Mostazo Torres Carolina González Arjona Francisco Javier Rando-Mu?oz Liver Transplantation and Hepatology Unit UGC de Aparato Digestivo Hospital Regional Universitario Department of Abdominals Diseases Hospital Nij Smellinghe Ziekenhuis

Chronic hepatitis B virus(HBV) infection is responsible for up to 30% of cases of liver cirrhosis and up to 53% of cases of hepatocellular carcinoma. Liver transplantation(LT) is the best therapeutic option for patients with end-stage liver failure caused by HBV. The success of transplantation, though, depends on receiving prophylactic treatment against post-transplant viral reactivation. In the absence of prophylaxis, liver transplantation due to chronic hepatitis B(CHB) is associated with high rates of viral recurrence and poor survival. The introduction of treatment with hepatitis B immunoglobulins(HBIG) during the 1990 s and later the incorporation of oral antiviral drugs have improved the prognosis of these patients. Thus, LT for CHB is now a universally accepted option, with an estimated 5 years survival of around 85% vs the 45% survival seen prior to the introduction of HBIG. The combination of lamivudine plus HBIG has for many years been the most widely used prophylactic regimen. However, with the appearance of new more potent oral antiviral agents associated with less resistance(e.g., entecavir and tenofovir) for the treatment of CHB, new prophylactic strategies are being designed, either in combination with HBIG or alone as a monotherapy. These advances have allowed for more personalized prophylaxis based on the individual risk profile of a given patient. In addition, the small pool of donors has required the use of anti-HBc-positive donors(with the resulting possibility of transmitting HBV from these organs), which has been made possible by suitable prophylactic regimens.

关键词： Hepatitis B virus Liver tra nsplantation Recurrence prophylaxis Hepatitis B immunoglobulin

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Sex differences in Alzheimer's disease:an urgent research venue to follow

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Neural Regeneration Research 2024年第12期19卷 2569-2570页

作者： Raquel jiménez-Herrera Ana Contreras Juan D.Navarro-López Lydia jiménez-Díaz Neurophysiology&Behavior Lab University of Castilla-La ManchaSchool of Medicine of Ciudad RealCiudad RealSpain

Due to increasing life expectancy,the amount of people with dementia worldwide is expected to experience a substantial rise,with estimates indicating a growth from 55 million in 2019 to a staggering 139 million by the... 详细信息

关键词： Alzheimer predominant estimates

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Treatment of chronic hepatitis C with direct-acting antivirals: The role of resistance

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World Journal of Gastroenterology 2016年第29期22卷 6573-6581页

作者： miguel jiménez-pérez Rocío González-Grande pilar Espana Contreras Isabel pinazo Martínez Jesús de la Cruz Lombardo Raúl Olmedo Martín UGC de Aparato Digestivo Unidad de Hepatologia-Trasplante Hepatico Hospital Universitario Regional de Malaga 29010 Malaga Spain Liver transplantation and hepatology unit UGC de Aparato Digestivo Hospital Regional Universitario 29010 Malaga Spain

The use of direct-acting antivirals(DAAs) to treat chronic hepatitis C has resulted in a significant increase in rates of sustained viral response(around 90%-95%) as compared with the standard treatment of peginterferon/ribavirin. Despite this, however, the rates of therapeutic failure in daily clinical practice range from 10%-15%. Most of these cases are due to the presence of resistant viral variants, resulting from mutations produced by substitutions of amino acids in the viral target protein that reduce viral sensitivity to DAAs, thus limiting the efficacy of these drugs. The high genetic diversity of hepatitis C virus has resulted in the existence of resistance-associated variants(RAVs), sometimes even before starting treatment with DAAs, though generally at low levels. These preexisting RAVs do not appear to impact on the sustained viral response, whereas those that appear after DAA therapy could well be determinant in virological failure with future treatments. As well as the presence of RAVs, virological failure to treatment with DAAs is generally associated with other factors related with a poor response, such as the degree of fibrosis, the response to previous therapy, the viral load or the viral genotype. Nonetheless, viral breakthrough and relapse can still occur in the absence of detectable RAVs and after the use of highly effective DAAs, so that the true clinical impact of the presence of RAVs in therapeutic failure remains to be determined.

关键词： Direct-acting antivirals Resistance Treatment Hepatitis C virus

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Attaching CF3 groups to organic molecules using trifluoroacetates via ion-shielding photoelectrocatalysis

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Science China Chemistry 2024年第11期67卷 3495-3497页

作者： paula Visiedo-jiménez Francisco Juliá-Hernández Departamento de Química Inorgánica Facultad de Química Universidad de MurciaCampus de Espinardo

Fluorinated molecules play a protagonist role in pharmaceuticals, agrochemicals, and materials. The incorporation of fluoroalkyl groups into organic compounds provides them with unique chemical properties that are key...

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