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Cost-effectiveness of enhanced liver fibrosis test to assess liver fibrosis in chronic hepatitis C virus and alcoholic liver disease patients

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World Journal of Gastroenterology 2017年第17期23卷 3163-3173页

作者： Marcelo Soto Laura Sampietro-Colom Luis Lasalvia Aurea Mira Wladimiro Jiménez miquel navasa FundacióClínic per a la Recerca Biomèdica Health Technology Assessment Unit Hospital Clínic Siemens Healthcare Department of Clinical Microbiology Hospital Clínic Department of Biomedicine University of Barcelona IDIBAPS7.Liver Unit Hospital Clínic

AIM To assess liver fibrosis(LF) in hepatitis C virus(HCV) and alcoholic liver disease(ALD), estimate health outcomes and costs of new noninvasive testing strategies METHODS A Markov model was developed to simulate LF progression in HCV and ALD for a cohort of 40-yearold men with abnormal levels of transaminases. Three different testing alternatives were studied: a single liver biopsy; annual Enhanced liver fibrosis(ELF?) followed by liver stiffness measurement(LSM) imaging as a confirmation test if the ELF test is positive; and annual ELF test without LSM. The analysis was performed from the perspective of a university hospital in *** data were obtained from published literature. Costs were sourced from administrative databases of the hospital. Deterministic and probabilistic sensitivity analyses were *** In HCV patients, annual sequential ELF test/LSM and annual ELF test alone prevented respectively 12.9 and 13.3 liver fibrosis-related deaths per 100 persons tested, compared to biopsy. The incremental costeffectiveness ratios(ICERs) were respectively €13400 and €11500 per quality-adjusted life year(QALY). In ALD, fibrosis-related deaths decreased by 11.7 and 22.1 per 100 persons tested respectively with sequential ELF test/LSM and annual ELF test alone. ICERs were €280 and €190 per QALY, *** The use of the ELF test with or without a confirmation LSM are cost-effective options compared to a single liver biopsy for testing liver fibrosis in HCV and ALD patients in Spain.

关键词： Cost-effectiveness analysis Liver fibrosis Noninvasive diagnostic assessment Alcoholic liver disease Hepatitis C

Sustained low diffusing capacity in hepatopulmonary syndrome after liver transplantation

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World Journal of Gastroenterology 2006年第36期12卷 5878-5883页

作者： Graciela Martínez-Pallí Federico P Gómez Joan A Barberà miquel navasa Josep Roca Robert Rodríguez-Roisin Felip Burgos Conchi Gistau Serveis de Pneumologia Anestesiologia and Hepatologia. Institut d'Investigacions Biomèdiques August Pi i Sunyer Hospital Clínic Universitat de Barcelona Barcelona Spain Serveis de Pneumologia Anestesiologia and Hepatologia. Institut d’Investigacions Biomèdiques August Pi i Sunyer Hospital Clínic Universitat de Barcelona Barcelona Spain

AIM： To study the presence of sustained low diffusing capacity （DLco） after liver transplantation （LT） in patients with hepatopulmonary syndrome （HPS）. METHODS： Six patients with mild-to-severe HPS and 24 without HPS who underwent LT were prospectively followed before and after LT at mid-term （median, 15 mo）. HPS patients were also assessed at Iong-tem （median, 86 mo）. RESULTS： Before LT, HPS patients showed lower PaO2 （71 ± 8 mmHg）, higher AaPO2 （43 ± 10 mmHg） and lower DLco （54% ± 9% predicted）, due to a combination of moderate-to-severe ventilation-perfusion （VA/Q） imbalance, mild shunt and diffusion limitation, than non- HPS patients （94 ± 4 mmHg and 19 ± 3 mmHg, and 85% ± 3% predicted, respectively）（P 〈 0.05 each）. Seven non-HPS patients had also reduced DLco （70% ± 4% predicted）. At mid- and long-term after LT, compared to pre- LT, HPS patients normalized PaO2 （91 ± 3 mmHg and 87 ± 5 mmHg）, AaPO2 （14 ± 3 mmHg and 23 ± 5 mmHg） and all VA/Q descriptors （P 〈 0.05 each） without changes in DLco （53% ± 8% and 56% ± 7% predicted, respectively）. Post-LT DLco in non-HPS patients with pre- LT low DLco was unchanged （75% ± 6% predicted）. CONCLUSION： While complete VA/Q resolution in HPS indicates a reversible functional disturbance, sustained low DLco after LT also present in some non-HPS patients, points to persistence of sub-clinical liver-induced pulmonary vascular changes.

关键词： Carbon monoxide diffusing capacity Multiple inert gas elimination technique Pulmonary gas exchange Pulmonary vascular disorders Ventilation- perfusion relationships

The presence and outcome of biliary sphincter disorders in liver-transplant recipients according to the Rome IV classification

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Gastroenterology Report 2021年第4期9卷 299-305,I0001页

作者： Alejandro Fernandez-Simon Oriol Sendino Karina Chavez-Rivera Henry Córdova Jordi Colmenero Gonzalo Crespo Yilliam Fundora Franco Samaniego Pablo Ruiz Constantino Fondevila miquel navasa Andrés Cárdenas GI Unit Institut Clı´nic de Malalties Digestives i MetaboliquesHospital Clı´nicUniversity of BarcelonaBarcelonaSpain Institut d’Investigacions Biomèdiques August Pi-Sunyer(IDIBAPS)and Ciber de Enfermedades Hepáticas y Digestivas(CIBEREHD) BarcelonaSpain Liver Transplant Unit Institut Clínic de Malalties Digestives i MetabóliquesHospital ClínicUniversity of BarcelonaBarcelonaSpain

Background Biliary sphincter disorders after liver transplantation(LT)are poorly *** aim to describe the presence and outcome of patients with papillary stenosis(PS)and functional biliary sphincter disorders(FBSDs)after LT according to the updated Rome IV *** We reviewed all endoscopic retrograde cholangiopancreatographies(ERCPs)performed in LT recipients between January 2003 and December *** on clinical and endoscopic findings was obtained from electronic health records and endoscopy *** and clinical findings were collected at the time of ERCP and 1 month after *** Among the 1,307 LT recipients,336 underwent 849 ***(1.0%)patients met the updated Rome IV criteria for PS[former sphincter of Oddi dysfunction(SOD)type I]and 14 patients(1.0%)met the Rome IV criteria for FBSD(former SOD type II).Biliary sphincterotomy was performed in 13 PS and 10 FBSD *** month after sphincterotomy,bilirubin,gamma-glutamyl transferase and alkaline phosphatase levels decreased in 85%,61%,and 92%of those in the PS group(P¼0.019,0.087,and 0.003,respectively)and in 50%,70%,and 80%of those in the FBSD group(P¼0.721,0.013,and 0.093,respectively).All the 14 patients initially suspected of having a FBSD turned out to have a different diagnosis during the *** PS after LT is uncommon and occurs in only 1%of LT *** data do not support the presence of an FBSD after *** is a safe and effective procedure in LT recipients with PS.

关键词： sphincter of Oddi dysfunction liver transplantation biliary sphincterotomy papillary stenosis functional biliary sphincter disorder

Protein glycation:a wolf in sweet sheep’s clothing behind neurodegeneration

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Neural Regeneration Research 2024年第5期19卷 975-976页

作者： Ana B.Uceda Francisco Leal-Pérez miquel Adrover Institut Universitari d’Investigacióen Ciències de la Salut(IUNICS) Institut d’InvestigacióSanitària Illes Balears(IdISBa) Departament de Química Universitat de les Illes BalearsCtraPalma de MallorcaSpain

At the beginning of the 16th century,Paracelsus coined the maxim:“the dose makes the poison”.This principle can be applied to all living organisms,including organs and *** brain and its glial and neuronal cells are ... 详细信息

关键词： organs sheep sweet

Low field microwave absorption and magnetization process in CoFeNi electroplated wires

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Chinese Physics B 2008年第4期17卷 1430-1435页

作者： H.García-miquel G.V.Kurlyandskay E.T.S.I.Telecomunicación Dpto.Ing.ElectrónicaUniversidad Politcnica de ValenciaCamino de Vera s/nValencia 46022Spain Universidad del País Vasco UPV-EHU Dept.Electricidad y ElectrónicaApdo.644Bilbao 48080Spain Department of Physics Ferromagnetic Resonance GroupUniversity of MarylandCollege ParkMaryland 20742-4111USA

Ferromagnetic resonance （FMR）, Ferromagnetic antirresonance （FMAR） and low field magnetoimpedance （MI） are the characteristic features of high frequency losses in applied fields. While some results on FMR and FMAR in CoFeNi electroplated wires were reported earlier, here we present microwave absorption in CuBe wires electroplated by 1 μm FeCoNi magnetic layer at very low fields. These data are comparatively analysed together with longitudinal hysteresis loops in order to reveal the correlation between power absorption and magnetization processes. Microwave studies are made by using the cavity perturbation method at 9.65 GHz for a DC field parallel to the sample axis, and with microwave magnetic field hrf parallel or perpendicular to the wire axis. Two peaks have been observed in all samples, one is due to FMR, and the other is, at very low fields, related to MI. The MI peaks represent minima in power absorption. By comparing with the hysteresis loop we remark the close correspondence between the MI phenomena in the axial mode and the concomitant magnetization process.

关键词： microwave absorption magnetoimpedance electroplated wires

Are we giving azathioprine too late? The case for early immunomodulation in inflammatory bowel disease

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World Journal of Gastroenterology 2008年第36期14卷 5512-5518页

作者： María Josefina Etchevers Montserrat Aceituno miquel Sans Department of Gastroenterology Hospital Posadas Buenos Aires Argentina Department of Gastroenterology Hospital Clínic i Provincial/IDIBAPS Barcelona CIBER Enfermedades Hepáticas y Digestivas Spain

Inflammatory bowel disease (IBD) includes two entities, Crohn’s disease and ulcerative colitis. Both are chronic conditions with frequent complications and surgical procedures and a great impact on patient’s quality of life. The thiopurine antimetabolites azathioprine and 6-mercaptopurine are widely used in IBD patients. Current indications include maintenance therapy, steroid-dependant disease, fistula closure, prevention of infliximab immunogenicity and prevention of Crohn’s disease recurrence. Surprisingly, the wide use of immunosuppressants in the last decades has not decreased the need of surgery, probably because these treatments are introduced at too late stages in disease course. An earlier use of immunossupressants is now advocated by some authors. The rational includes: (1) failure to modify IBD natural history of present therapeutic approach, (2) demonstration that azathioprine can induce mucosal healing, a relevant prognostic factor for Crohn’s disease and ulcerative colitis, and (3) demonstration that early immunossupression has a very positive impact on pediatric, recently diagnosed Crohn’s disease patients. We are now awaiting the results of new studies, to clarify the contribution of azathioprine, as compared to infliximab (SONIC Study), and to demonstrate the usefulness of azathioprine in recently diagnosed adult Crohn’s disease patients (AZTEC study).

关键词： Inflammatory bowel disease Crohn's disease Ulcerative colitis Immunosuppressants Azathioprine

Familial aggregation in inflammatory bowel disease:Is it genes or environment?

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World Journal of Gastroenterology 2011年第22期17卷 2715-2722页

作者： Tiago Nunes Gionata Fiorino Silvio Danese miquel Sans Department of Gastroenterology Hospital Clinic i Provincial/IDIBAPS CIBER EHD 08036 Barcelona Spain Division of Gastroenterology IRCCS Istituto Clinico Humanitas Rozzano Milan 20089 Italy

Inflammatory bowel disease (IBD) develops in genetically susceptible individuals due to the influence of environmental factors, leading to an abnormal recognition of microbiota antigens by the innate immune system which triggers an exaggerated immune response and subsequent bowel tissue damage. IBD has been more frequently found in families, an observation that could be due to either genetic, environmental or both types of factors present in these families. In addition to expanding our knowledge on IBD pathogenesis, defining the specific contribution to familial IBD of each one of these factors might have also clinical usefulness. We review the available evidence on familial IBD pathogenesis.

关键词： Inflammatory bowel disease Familial aggregation Familial clustering Environmental factors Genetics Genome wide association studies

Depressive symptoms in neurodegenerative diseases

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World Journal of Clinical Cases 2015年第8期3卷 682-693页

作者： miquel Baquero Nuria Martín Servei de Neurologia Hospital Universitari i Politècnic La Fe

Depressive symptoms are very common in chronic conditions. This is true so for neurodegenerative diseases. A number of patients with cognitive decline and dementia due to Alzheimer's disease and related conditions like Parkinson's disease, Lewy body disease, vascular dementia, frontotemporal degeneration amongst other entities, experience depressive symptoms in greater or lesser grade at some point during the course of the illness. Depressive symptoms have aparticular significance in neurological disorders, specially in neurodegenerative diseases, because brain, mind, behavior and mood relationship. A number of patients may develop depressive symptoms in early stages of the neurologic disease, occurring without clear presence of cognitive decline with only mild cognitive deterioration. Classically, depression constitutes a reliable diagnostic challenge in this setting. However, actually we can recognize and evaluate depressive, cognitive or motor symptoms of neurodegenerative disease in order to establish their clinical significance and to plan some therapeutic strategies. Depressive symptoms can appear also lately, when the neurodegenerative disease is fully developed. The presence of depression and other neuropsychiatric symptoms have a negative impact on the quality-of-life of patients and caregivers. Besides, patients with depressive symptoms also tend to further decrease function and reduce cognitive abilities and also uses to present more affected clinical status, compared with patients without depression. Depressive symptoms are treatable. Early detection of depressive symptoms is very important in patients with neurodegenerative disorders, in order to initiate the most adequate treatment. We review in this paper the main neurodegenerative diseases, focusing in depressive symptoms of each other entities and current recommendations of management and treatment.

关键词： Neurodegenerative diseases Alzheimer Depressive symptoms Frontotemporal degeneration Vascular dementia Lewy body disease Depression Dementia

Multi-agent system simulation for urban policy design:open space land use change problem

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International Journal of Modeling, Simulation, and Scientific Computing 2016年第2期7卷 20-37页

作者： Roman Buil miquel Angel Piera Egils Ginters Logistics and Aeronautics Unit Universitat Autonoma de Barcelona c.Emprius2 Sabadell 08202Spain Vidzeme University of Applied Sciences Cesu Street 4 Valmiera LV-4201Latvia

Multi-agent system(MAS)models have been increasingly applied to the simulation of complex phenomena in different areas,providing successful and credible *** behavior related to a specific urban activity(i.e.,recreation activities in a park,using bicycle for mobility purposes)can be modeled as an agent(actor)with several affinities and preferences which are dependent on aspects that affect the activity.A particular application of a MAS approach is in area of urban policy design,in which policies should be designed considering citizens needs,preferences and *** an open space in a city is available(i.e.,an industry is moved to an industrial area),a land use policy should contribute to identify the new use for the urban *** are different land use policies that can be applied depending on which services or facilities must be empowered in the *** is important to identify the correct policy in order to satisfy present citizens needs but considering also the future needs in a social changing context.A socio-technological simulation model has been developed to allow citizens to get a better understanding of the urban problem,its dynamics and explore the sustainability of the different solutions.,enhancing citizens to participate in the urban decisions through new technologies(i.e.,e-participation).This paper illustrates an open space MAS simulation model for land use design policies in which citizens can check their opinion and get a better understanding of the different choices and its acceptability by the community considering not only present neighborhood profiles,but also future neighborhood *** is the first step before the development of the final software including a user friendly interface to let citizens with different cultural profiles to perform simulations as an essential and neutral tool to reach consensus during the decision-making process in urban policy design.

关键词： Agent simulation,urban policy open space e-governance e-participation