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Impact of mass screening for gluten-sensitive enteropathy in working population

World Journal of Gastroenterology 2009年第11期15卷 1331-1338页

作者： Meritxell Mariné Fernando Fernández-Baares montserrat alsina Carme Farré montserrat Cortijo Rebeca Santaolalla Antonio Salas Margarita Tomàs Elias Abugattas Carme Loras Ingrid Ordás Josep M Viver Maria Esteve Department of Gastroenterology University Hospital of Mútua de TerrassaResearch Foundation Mútua de TerrassaUniversity of Barcelona08221 TerrassaCataloniaSpain Department of Immunology(Catlab) University Hospital of Mútua de TerrassaResearch Foundation Mútua de TerrassaUniversity of Barcelona08221 TerrassaCataloniaSpain Department of Biochemistry Sant Joan de DéuHospitalEsplugues08950 CataloniaSpain Occupational Health Department Egarsat(Prevention Society)Sant Cugat del Vallès08173 CataloniaSpain Department of Pathology University Hospital of Mútua de TerrassaResearch Foundation Mútua de TerrassaUniversity of Barcelona08221 TerrassaCataloniaSpain

AIM:To assess:(1)frequency and clinical relevanceof gluten sensitive enteropathy(GSE)detected by serology in a mass screening program;(2)sensitivity of antitransglutaminase(tTGA)and antiendomysium antibodies(EmA);and(3)adherence to gluten-free diet(GFD)and follow-up. METHODS:One thousand,eight hundred and sixtyeight subjects recruited from an occupational health department underwent analysis for tTGA and EmA and, if positive,duodenal biopsy,DQ2/DQ8 genotyping, clinical feature recording,blood tests,and densitometry were ***>98%of individuals had tTGA <2 U/mL,this value was established as the cut-off limit of normality and was considered positive when confirmed twice in the same *** to a GFD and follow up were registered. RESULTS:Twenty-six(1.39%)subjects had positive tTGA and/or EmA,and 21 underwent biopsy:six Marsh Ⅲ(oneⅢa,fourⅢb,oneⅢc),nine MarshⅠand six Marsh 0(frequency of GSE 1:125).The sensitivity of EmA for GSE was 46.6%(11.1%for MarshⅠ,100% for MarshⅢ),while for tTGA,it was 93.3%(88.8% for MarshⅠ,100%for MarshⅢ).All 15 patients with abnormal histology had clinical features related to ***ⅠandⅢsubjects had more abdominal pain than Marsh 0(P=0.029),and a similar trend was observed for distension and *** differences in the percentage of osteopenia were found between MarshⅠandⅢ(P=0.608).Adherence to follow-up was 69.2%.Of 15 GSE patients,66.7%followed a GFD with 80%responding to it. CONCLUSION:GSE in the general population is frequent and clinically relevant,irrespective of histological *** is the marker of *** screening programs are useful in identifying patients who can benefit from GFD and follow-up.

关键词： Antitransglutaminase and antiendomysiumantibodies Celiac disease Lymphocytic enteritis Massscreening

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Morphodynamics of sandy beaches under the influence of storm sequences:Current research status and future needs

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Water Science and Engineering 2019年第3期12卷 221-234页

作者： Sonja Eichentopf Harshinie Karunarathna Jose M.alsina Department of Civil and Environmental Engineering Imperial College London South Kensington Campus London SW7 2AZ UK College of Engineering Swansea University Bay Campus Swansea SA1 8EN UK Laboratori d'Enginyeria Marítima Universitat Politecnica de Catalunya Barcelona 08034 Spain

This paper reviews and discusses the current research status, trends, and future needs in the field of beach morphodynamics under the influence of storm *** paper reviews how the three main research methods, field investigations, numerical modelling, and physical modelling, have been used to study beach morphodynamics during storm *** quantitative definitions of storm sequences at different sites are presented and *** is shown that the definition of storm sequences is site-specific and requires knowledge of the storm climate, beach characteristics, and the temporal scale of beach ***, the paper brings together currently available approaches aimed at describing the effect of storm sequences on beach erosion in a general *** importance of storm chronology and the effects of an extreme storm within a sequence of storms are *** that, the more poorly studied aspect of beach recovery in between storms within a sequence is *** indicators for defining beach recovery, namely the shoreline location, sediment volumes, and the beach state, are identified and ***, important research needs, including the need for detailed physical modelling, are identified.

关键词： Storm sequences Beach morphodynamics Beach erosion Extreme storms Return period Beach recovery

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An Evolutionary Approach for Personalized Therapy in Multiple Myeloma

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Applied Mathematics 2016年第2期7卷 159-169页

作者： Ariosto S. Silva Ashley Durand Maria C. Ribeiro Melissa alsina Kenneth Shain Rachid Baz Department of Cancer Imaging and Metabolism H. Lee Moffitt Cancer Center and Research Institute Tampa FL USA Department of Total Cancer Care H. Lee Moffitt Cancer Center and Research Institute Tampa FL USA Department of Malignant Hematology H. Lee Moffitt Cancer Center and Research Institute Tampa FL USA

Most patients with multiple myeloma (MM) respond well to initial therapy, but invariably relapse due to evolution of resistant phenotypes. Here we examine the evolutionary dynamics of proliferation of resistant MM phenotypes during therapy. By applying computational models to data from three clinical trials for newly diagnosed MM patients, we have quantified the size and level of chemoresistance of subpopulations within the tumor burden in 124 patients, prior to and during therapy. Subsequently, we used the computational models to explore an alternative strategy of “adaptive therapy” (AT), which includes defined treatment holidays, to improve the duration of “controlled disease” (CD). Simulations showed that AT could prolong CD in all three trials: 50.0% vs. 11.1% 50-month CD for a single agent approach in older adults (P = 0.0123), 80.4% vs. 58.8% 60-month CD for a multi-agent bortezomib based therapy (P = 0.0082), and 54.0% vs. 24.0% 60-month CD for a multi-agent lenalidomide based therapy (P < 0.0001). Increases in duration of CD resulted from the stabilization of tumor burden, which in turn would delay the growth of chemoresistant sub-populations in patients with partial (PR), or very good partial response (VGPR). These computational algorithms suggest that AT may provide an alternative and feasible therapeutic management strategy in MM.

关键词： Multiple Myeloma Adaptive Therapy Evolutionary Dynamics Competitive Release

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Genetic and experimental evidence for the involvement of the CD6 lymphocyte receptor in psoriasis

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Cellular & Molecular Immunology 2018年第10期15卷 898-906页

作者： Marta Consuegra-Fernández Marc Julià Mario Martínez-Florensa Fernando Aranda Cristina Català Noelia Armiger-Borràs María-Teresa Arias Francisca Santiago Antonio Guilabert Anna Esteve Carlos Muñoz Carlos Ferrándiz José-Manuel Carrascosa Edurne Pedrosa Jorge Romaní Mercèalsina José-Manuel Mascaró-Galy Francisco Lozano Immunoreceptores del Sistema Innat i Adaptatiu Institut d'Investigacions Biomèdiques August Pi i Sunyer(IDIBAPS)Barcelona 08036Spain Servicio de Dermatologia Hospital Universitario de BasurtoBilbao 48013Spain Servei d’Immunologia Centre de Diagnòstic BiomèdicHospital Clínic de BarcelonaBarcelona 08036Spain Servei de Dermatologia Hospital General de GranollersBarcelona 08402Spain Centre d’Estudis Epidemiològics sobre les ITS i Sida de Catalunya(CEEISCAT) ASPCCIBER Epidemiologia y Salud PúblicaBadalona 08916Spain Servei de Dermatologia Hospital Universitari Germans Trias i PujolBadalona 08916Spain Laboratori d’Immunobiologia per Investigaciói Aplicacions al Diagnòstic Banc de Sang i Teixits(BST)Institut d’Investigacióen Ciències de la Salut Germans Trias i PujolDepartament de Biologia Cel·lularFisiologia i ImmunologiaUniversitat Autònoma de BarcelonaBellaterra 08193Spain Servei de Dermatologia Consorci Sanitari Parc Taulí08208 Sabadell.Universitat Autónoma de BarcelonaBellaterra 08193Spain Servei de Dermatologia Hospital Clínic de BarcelonaBarcelona 08036Spain Departament de Biomedicina Universitat de BarcelonaBarcelona 08036Spain

Psoriasis is a chronic inflammatory skin disease with a strong genetic background and is triggered by environmental *** evidence supports CD6,a lymphocyte surface receptor mostly expressed by T cells,as a putative target in ***,a humanized anti-CD6 antibody has been assayed for the treatment of certain autoimmune disorders,including ***,we present novel evidence in mice and humans for a direct involvement of CD6 in psoriasis ***,an attenuated form of imiquimod-induced psoriasis-like skin inflammation was demonstrated in CD6-deficient mice,as deduced from lower epidermal thickness and local reduced production of pro-inflammatory cytokines,namely,***,isolated CD4+CD62L+T cells from CD6-deficient mice displayed decreased in vitro T-helper type 17 ***,a statistically significant association between CD6 single-nucleotide polymorphisms(rs17824933,rs11230563 and rs12360861)and more severe forms of psoriasis was demonstrated in a cohort of 304 patients at three public hospitals from the metropolitan area of *** together,these results provide new supportive evidence of the contribution of the CD6 lymphocyte receptor in psoriasis at both experimental and clinical levels.

关键词： ALCAM CD5 CD6 lymphocyte psoriasis

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Interleukin 28B-related polymorphisms: A pathway for understanding hepatitis C virus infection?

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World Journal of Gastroenterology 2013年第42期19卷 7399-7404页

作者： Raquel Francine Liermann Garcia Simone Moreira Ana Lucia de Araújo Ramos Leslie Ecker Ferreira Angelo Alves de Mattos Cristiane Valle Tovo Lysandro alsina Nader Juliene Antonio Ramos Edson Rondinelli Arnaldo de Jesus Dominici Christian Evangelista Garcia Mauro de Souza Leite Pinho Carlos Eduardo Brando-Mello Cristiane Alves Villela-Nogueira Paulo Henrique Condeixa de Frana Departamento de Medicina Universidade da Regio de Joinville/UnivilleJoinville89219-719 Santa CatarinaBrazil Departamento de Clinica Médica e Cirurgia Geral Hospital Municipal So José Joinville89202-000 Santa CatarinaBrazil Departamento de Clínica Médica Servio de HepatologiaFaculdade de Medicina/Hospital Universitário Clementino Fraga Filho/Universidade Federal do Rio de Janeiro21941-913 Rio de JaneiroBrazil Servio de Gastroenterologia e Hepatologia Irmandade da Santa Casa de Misericórdia/ISCMPAPorto Alegre90020-090 Rio Grande do SulBrazil Servio de Endoscopia Universidade Federal de Pelotas/UFPelPelotas96010-610 Rio Grande do SulBrazil Instituto de Biofísica Carlos Chagas Filho/UFRJ 21941-902 Rio de JaneiroBrazil Departamento de Gastroenterologia Hospital Universitário da Universidade Federal do Maranh o/UFMASo Luis65020-560 MaranhoBrazil Servio de Gastroenterologia Hospital Universitário Gaffrée Guinle/HUGG/UNIRIO20270-004 Rio de JaneiroBrazil

AIM:To analyze the role of rs12979860 and rs8099917polymorphisms in hepatitis C virus(HCV)genotype 1infection of ***:A total of 145 adult patients diagnosed with genotype 1 chronic hepatitis C(CHC)who had completed a 48-wk regimen of pegylated-interferonα-2a or-2b plus ribavirin combination therapy were recruited from six large urban healthcare centers and199 healthy blood donors(controls)from a single site between January 2010 and January *** on the patients’response to treatment was *** chain reaction-restriction fragment length polymorphism genotyping of the interleukin(IL)28B gene fragment encompassing the single nucleotide polymorphisms(SNPs)rs12979860(C/T)and rs8099917(T/G)was carried out for 79 of the CHC patients and 199 of the ***-directional amplicon sequencing of the two SNPs was carried out for the remaining 66 CHC ***:SNP rs12979860 genotyping was successful in 99.5%of the controls and 97.2%of the CHC patients,whereas the SNP rs8099917 genotyping was successful in 95.5%of the controls and 100%of the CHC *** genotype and allele distributions for both rs12979860 and rs8099917 were significantly different between the control and CHC patient groups,with significantly higher genotype frequencies of CC and TT in the controls(P=0.037 and 0.046,respectively)and of TT and GG in the CHC patients(P=0.0009and 0.0001,respectively).Analysis of the CHC patients who achieved sustained virological response(SVR)to treatment(n=55)indicated that the rs12979860 C allele and CC genotype were predictors of SVR(P=0.02).No significant correlation was found between rs8099917 genotypes and treatment response,but carriers of the T allele showed significantly higher rates of SVR(P=0.02).Linkage disequilibrium analysis of the group that achieved SVR showed a significant association between rs12979860 and rs8099917(P=0.07).CONCLUSION:The higher allele frequency of rs12979860 C and rs8099917 T observed in non-HCVinfec

关键词： Hepatitis C Interleukin 28B Single nucleotide polymorphisms Sustained virological response Brazil

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肠道疾病的临床特征对大肠癌/炎性肠病的诊断价值:一项基于50岁以下社区患者的大型病例对照研究

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中国全科医学 2017年第18期 2207-2207页

作者： STAPLEY S A RUBIN G P alsina D 本刊编辑部

背景 50岁以下人群的大肠癌和炎性肠病发病率呈上升趋势。目的本研究旨在调查50岁以下社区大肠癌/炎性肠病患者的临床特征,对其诊断价值进行量化评估,并探讨哪些有此临床特征的患者能从潜在的严重结直肠疾病调查中获益。设计与场所本研... 详细信息

背景 50岁以下人群的大肠癌和炎性肠病发病率呈上升趋势。目的本研究旨在调查50岁以下社区大肠癌/炎性肠病患者的临床特征,对其诊断价值进行量化评估,并探讨哪些有此临床特征的患者能从潜在的严重结直肠疾病调查中获益。设计与场所本研究为配比病例对照研究。使用的社区病历来源于英国临床研究数据库。方法本研究于2000-2013年选择50岁以下的大肠癌社区患者1 661例,50岁以下的炎性肠病社区患者9 578例。两组人群均以1:3的比例选择配比对照对象,大肠癌社区患者的对照人群为3 979例,炎性肠病社区患者的对照人群为22 947例。患者确诊之前,对大肠癌/炎性肠病的临床特征对该病诊断的价值进行评估。结果直肠出血、排便习惯改变、腹泻、炎性因子水平增高、血小板计数增多、腹痛、低平均红细胞体积、低血红蛋白、白细胞计数增多、肝酶水平增高是大肠癌/炎性肠病的独立影响因素(P3%;排便习惯改变合并低平均红细胞体积、血小板计数增多或低血红蛋白对大肠癌/炎性肠病的阳性预测值>3%;腹泻合并血小板计数增多对大肠癌/炎性肠病的阳性预测值>3%。结论本研究对50岁以下社区肠道疾病患者的临床特征对大肠癌/炎性肠病的诊断价值进行了量化评估。直肠出血和排便习惯改变合并血液学检查异常结果对大肠癌/炎症性肠病具有较高诊断价值。有助于医生优先安排有临床症状但未能及时确诊的患者进行结肠镜检查。

关键词：炎性肠病阳性预测值大肠癌肠道疾病肠疾病诊断价值社区患者临床特征

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更年期医学:欧洲男女更年期协会2004／2005关于围绝经期和绝经后激素补充治疗的立场声明

更年期医学:欧洲男女更年期协会2004／2005关于围绝经期和绝经后...

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第二次全国绝经相关问题高级学术研讨会

作者： Sven O．Skouby． Farook Al-Azzawi David Barlow Joaquin Calaf-alsina Erdogan Ertüngealp Anne Gompel Alessandra Graziottin Decebal Hudita Amos ines Serge Rozenberg Gran Samsioe John C．Stevenson 陈瑛

目前从大量的随机对照临床试验(RCT)中已得出结论性证据:对于经历着令人痛苦的更年期症状的围绝经期和绝经后妇女,任何形式的全身HRT均可以缓解这些症状,没有其它治疗手段能产生相似效果。尽管这种证据与日俱增,但如何提供最好的临床医... 详细信息

目前从大量的随机对照临床试验(RCT)中已得出结论性证据:对于经历着令人痛苦的更年期症状的围绝经期和绝经后妇女,任何形式的全身HRT均可以缓解这些症状,没有其它治疗手段能产生相似效果。尽管这种证据与日俱增,但如何提供最好的临床医疗以减轻绝经症状和预防较远期的绝经后退化性疾病,仍在争论之中。当提供更年期医药时,HRT剂量和方案的个体化是基于与症状的严重程度和绝经时间相关的最低有效剂量的原则。然而,在有症状的妇女中,尚没有多少关于长期应用不同HRT方案的资料,赖以说明心血管疾病,乳腺癌和骨质疏松症基线风险的影响。在大多数病例中,个体化的处方联同生活方式的调整就可能对更年期症状、生活质量(QoL)、性问题和骨质疏松症产生最终有益的作用,罕见严重副反应。欧洲男女更年期协会(EMAS)基于最近的流行病学研究,其中不少是来自WHI中单用雌激素组的结果,支持在有症状的妇女中进行新HRT方案的研究,以提高临床中受益和风险之间的平衡,包括生活质量方面特有的信息: 并解释美国和欧洲之间在治疗模式上的传统差异,以及在BMI、生活方式和饮食习惯方面的不同所产生的影响。对于早绝经(小于45岁) 妇女,现有资料支持HRT所特有的总体益处。目前,具有骨质疏松性骨折高危险性的妇女可考虑应用较长期的全身HRT,尤其是当其它治疗措施既不恰当又疗效不佳时,因为此时收益大于风险。而对于泌尿生殖道症状,已认为长期的局部雌激素治疗可能安全和有效。

关键词： EMAS立场声明更年期医药围绝经期绝经后 HRT

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更年期医学:欧洲男女更年期协会2004/2005关于围绝经期和绝经后激素补充治疗的立场声明

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国外医学（妇幼保健分册） 2005年第5期16卷 319-322页

作者： Sven O.Skouby Farook Al-Azzawi David Barlow Joaquin Calaf-alsina Erdogan Ert ungealp Anne Gompel Alessandra Graziottin Decebal Hudita Amos ines Serge Rozenberg Gran Samsioe John C.Stevenson 陈瑛

目前从大量的随机对照临床试验(RCT)中已得出结论性的证据:对于经历令人痛苦的更年期症状的围绝经期和绝经后妇女,任何形式的全身HRT均可以缓解症状,没有其它治疗手段能产生相似效果。尽管这种证据与日俱增,但如何提供最好的临床医疗以... 详细信息

目前从大量的随机对照临床试验(RCT)中已得出结论性的证据:对于经历令人痛苦的更年期症状的围绝经期和绝经后妇女,任何形式的全身HRT均可以缓解症状,没有其它治疗手段能产生相似效果。尽管这种证据与日俱增,但如何提供最好的临床医疗以减轻绝经症状和预防较远期的绝经后退化性疾病,仍在争论之中。当提供更年期医药时,HRT的剂量和方案的个体化是基于与症状的严重程度和绝经时间相关的最低有效剂量的原则。然而,在有症状的妇女中,尚没有多少关于长期应用不同HRT方案的资料,同时赖以说明心血管疾病、乳腺癌和骨质疏松症的基线风险的影响。在大多数病例中,个体化的处方联同生活方式的调整就可能对更年期症状、生活质量、性问题和骨质疏松症产生最终有益的作用,罕见严重副反应。基于最近的流行病学研究,不少是来自WHI中单用雌激素组的结果,欧洲男女更年期协会(EMAS)支持在有症状的妇女中进行新的HRT方案的研究,以提高临床中受益和风险之间的平衡,包括生活质量方面特有的信息;并解释美国和欧洲之间在治疗模式上的传统差异,以及在BMI、生活方式和饮食习惯方面的不同所产生的影响。对于早绝经(<45岁)的妇女,现有的资料支持HRT所特有的总体益处。目前,具有骨质疏松性骨折高危险性的妇女可考虑应用较长期的全身HRT,尤其是当其它治疗措施既不恰当又疗效不佳时,因为此时收益大于风险。而对于泌尿生殖道症状,已认为长期的局部雌激素治疗可能安全和有效。

关键词：男女更年期协会立场声明更年期医药围绝经期绝经后激素补充治疗更年期症状绝经后妇女围绝经期激素补充治疗欧洲协会随机对照临床试验 HRT方案最低有效剂量

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