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Insulinoma after sleeve gastrectomy:A case report

World Journal of Clinical Cases 2022年第18期10卷 6227-6233页

作者： Miry Lobaton-Ginsberg pilar sotelo-gonzález Claudia Ramirez-Renteria Fany Gabriela Juárez-Aguilar Aldo Ferreira-Hermosillo Facultad de Medicina Universidad Anáhuac México NorteMexico City 52786Mexico Servicio de Endocrinología Hospital de EspecialidadesCentro Médico Nacional Siglo XXIIMSSMexico City 06720Mexico Unidad de Investigación Médica en Enfermedades Endocrinas Instituto Mexicano del Seguro SocialMexico City 06720Mexico Servicio de Anatomía Patológica Hospital de Especialidades del Centro Médico Nacional Siglo XXIIMSSMexico City 06720Mexico

BACKGROUND Laparoscopic sleeve gastrectomy(LSG)has been proposed as an effective and durable treatment for severe obesity and glucose metabolism disorders,and its prevalence has increased from 5%to 37%since *** common complication after bariatric surgery is a postprandial hyperinsulinemic hypoglycemic *** rare,insulinomas can cause this state,where symptoms are more common in the fasting state;thus,evaluation of insulin secretion is *** now,there have been no reports of insulinoma after *** SUMMARY We describe the case of a 43-year-old woman who was referred to the obesity clinic 2 years after LSG was *** had symptoms of hypoglycemia predominantly in the fasting state and documented hypoglycemia of less than 30 mg/d L,which are compatible with Whipple’s ***,dumping syndrome was suspected,but after a second low fasting plasma glucose was documented,a 72-h fasting test was performed that tested *** tomography and endoscopic ultrasound were performed,identifying the presence of a homogeneous hypoechoic semioval tumoral lesion in the *** diagnosis was compatible with *** laparoscopic enucleation of the insulinoma,the symptoms and hypoglycemia *** histopathological report described a well-differentiated grade 2 neuroendocrine tumor with positive chromogranin and synaptophysin and Ki67 immunopositivity in 4%of the neoplastic *** Insulinoma after LSG is a rare condition,and clinicians must be aware of it,especially if the patient has hypoglycemic symptoms during the fasting state.

关键词： Insulinoma Hypoglycemia Bariatric surgery Glucagon-like peptide 1 amide Neuroendocrine tumors Case report

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Seventeenth-century Seville houses:a survey by the Alarife Juan De Legarra(1637)

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Built Heritage 2024年第2期8卷 13-32页

作者： pilar Moya-Olmedo María Núñez-gonzález Fernando Vilaplana-Villajos Departamento de Ideación Gráfica Arquitectónica Escuela Técnica Superior de Arquitectura Universidad Politécnica de MadridAv.de Juan de Herrera 428040MadridSpain Departamento de Expresión Gráfica Arquitectónica Escuela Técnica Superior de Arquitectura Universidad de SevillaAv.de Reina Mercedes 2Seville41012Spain

Despite the wealth of preserved information,research on the domestic architecture of Seville has been *** of this historical data is available in survey books that were formally compiled in Seville from the Modern Age *** books had detailed descriptions and sometimes illustrations provided by surveyors who were commissioned by owners or *** intention of this study is to illustrate that the information contained in building surveys goes beyond simple descriptions or measurements often accompanied by *** are a comprehensive account that,even centuries later,help reconstruct the architecture,material culture and everyday life that no longer *** research contributes to the understanding of the domestic architectural history of Seville by focusing on one specific survey(a collection of drawings and a written description)extracted from the Hospital de las Cinco Llagas Collection,which is found in the Seville Provincial Council *** least one of the drawings and the written survey can be attributed to the Alarife(architect or master builder)Juan de Legarra,who signed them in *** research explores the architectural development of the city,offering fresh insights into its architecture,heritage,and *** supplements existing historical,visual,and written records derived from prior studies with a meticulously curated ***,it uses visualisation techniques to reconstruct buildings,augmenting the *** endeavour has yielded anticipated benefits,particularly in facilitating visual *** surveys have proven to be invaluable for historical inquiry,yielding unexpected insights through the thorough analysis of both written and graphic sources which serve as a basis for hypothetical construction plans due to their detailed ***,this study has contributed to enriching both historical and architectural *** incorporation of digital technologies into this architec

关键词： Historical documentation Survey Cultural heritage Virtual architecture Domestic architecture Archaeology

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Medical consultation in ulcerative colitis:Key elements for improvement

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World Journal of Gastroenterology 2023年第6期29卷 917-925页

作者： Yago gonzález-Lama Elena Ricart Ana Cábez pilar Fortes Susana Gómez Francesc Casellas Inflammatory Bowel Disease Unit Department of Gastroenterology and HepatologyHospital Universitario Puerta de Hierro-MajadahondaMadrid 28222Spain Inflammatory Bowel Disease Unit Department of GastroenterologyHospital ClínicBarcelona 08036Spain Biomedical Research Networking Center in Hepatic and Digestive Diseases(CIBERehd) Barcelona 08036Spain Department of Medical Pfizer SpainMadrid 28108Spain Servicio de Reumatología Hospital Universitario de SalamancaSalamanca 37007Spain Department of Gastroenterology Vall d'Hebron Research InstituteBarcelona 08035Spain

Ulcerative colitis(UC)is a chronic inflammatory disease with a high *** order to improve patient outcomes,the clinician-patient relationship in daily practice is *** guidelines provide a framework for UC diagnosis and ***,standard procedures and the medical content focused upon medical consultations in UC patients has not yet been ***,UC is a complex disease,given that patient characteristics and patient needs have been proven to vary during clinical consultation since establishing the diagnosis and upon the course of the *** this article,we have discussed the key elements and specific objectives to consider in medical consultation,such as diagnosis,first visits,follow-up visits,active disease patients,patients on topical therapies,new treatment initiation,refractory patients,extra-intestinal manifestations,as well as challenging *** key elements have been mentioned to comprise effective communication techniques,motivational interviewing(MI),as well as information and educational aspects,or organizational *** key elements to be implemented in daily practice were reported to comprise several general principles like duly prepared consultations,in addition to honesty and empathy with patients,as well as effective communication techniques,MI,information and educational points,or organizational *** role of other healthcare professionals such as specialized nurses,psychologists,or the use of checklists was also discussed and commented on.

关键词： Ulcerative colitis Patient experience Shared decision making Medical consultation Motivational interviewing Patient education

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Incidence, prevalence, and demographic characteristics of ocular cicatricial pemphigoid in Colombia: data from the National Health Registry 2009-2019

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International Journal of Ophthalmology(English edition) 2021年第11期14卷 1765-1770页

作者： Carlos Cifuentes-gonzález Stefania Amaris-Martínez Juliana Reyes-Guanes pilar Uribe-Reina Alejandra de-la-Torre Neuroscience Research Group Escuela de Medicina y Ciencias de la SaludUniversidad del RosarioBogota 111221Colombia Escuela Barraquer Research Group Escuela Superior de Oftalmología del Instituto Barraquer de AméricaBogota 110111Colombia

AIM:To provide an epidemiological characterization of ocular cicatricial pemphigoid(OCP)in ***:We conducted a cross-sectional study using *** applied the specific code of the International Classification of Diseases for Ocular Pemphigoid,from 2009-2019 to estimate prevalence,incidence,and the demographic status of the disease in ***:The estimated average prevalence was 0.22 per 1000000 inhabitants,and the estimated average incidence was 0.24 per 1000000 *** a female predominance of 62.5%,and a male/female ratio of 1:*** group of patients diagnosed with the disease after the age of 80 presented the highest *** departments with the highest prevalence were Antioquia,Bogotá,and ***:There are important differences between worldwide and Colombian prevalence and incidence data,which may be related to genetic and epigenetic factors,and the possible underdiagnosis of the *** to the results,OCP is an extremely rare disease in ***,it is important to encourage awareness of the disease due to its devastating consequences.

关键词： ocular cicatricial pemphigoid epidemiology incidenee ophthalmology Colombia autoimmune diseases

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Insects as alternative feed for ruminants:comparison of protein evaluation methods

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Journal of Animal Science and Biotechnology 2022年第4期13卷 1143-1150页

作者： Pablo G.Toral gonzalo Hervás Mariana Gabriela gonzález-Rosales Alejandro G.Mendoza Lizbeth E.Robles-Jiménez pilar Frutos Instituto de Ganadería de Montaña(CSIC-University of León) Finca Marzanas s/n24346 GrullerosLeónSpain Facultad de Medicina Veterinaria y Zootecnia Universidad Autónoma del Estado de MéxicoNo.100 Instituto Literario 100Col.Centro50000 TolucaEstado de MéxicoMexico.

Background:The high dependence of intensive ruminant production on soybean meal and the environmental impact of this crop encourage the search for alternative protein-rich *** use of insects seems promising,but the extent of their ruminal protein degradation is largely *** parameter has major influence not only on N utilization efficiency but also on the environmental burden of ruminant *** addition,although assessing ruminal N degradation represents a key first step to examine the potential of new feeds,it is a challenging task due to the lack of a reference *** study was conducted to investigate the potential of 4 insects(Tenebrio molitor,Zophobas morio,Alphitobius diaperinus and Acheta domesticus)as alternative protein sources for ruminants,using 3 methodologies:1)a regression technique based on the in vitro relationship between gas production and ammonia-N concentration;2)a conventional in vitro technique of batch cultures of ruminal microorganisms,based on filtering the incubation residue through sintered glass crucibles;and 3)the in situ nylon bag *** in vitro intestinal digestibility of the non-degraded protein in the rumen was also *** meal was used as a reference ***:Comparison of evaluation methods(regression,in vitro and in situ)did not allow to reliably select a single value of ruminal N degradation for the studied substrates,but all techniques seem to establish a similar ranking,with good correlations between methods,particularly between regression and in situ *** of the methodology,nitrogen from the 4 insects(with contents ranging from 81 to 112 g/kg of dry matter)did not show high ruminal degradation(41–76%),this value being always lower than that of soybean ***,the in vitro intestinal digestibility of non-degraded N was relatively high in all feeds(≥64%).Conclusion:Overall,these results support the potential of the 4 studied insects as alternative feedstu

关键词： In situ In vitro Livestock Nitrogen degradation Sheep

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Stem cell therapy in inflammatory bowel disease: A promising therapeutic strategy?

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World Journal of Stem Cells 2015年第2期7卷 343-351页

作者： Ana I Flores gonzalo J Gómez-Gómez ángeles Masedo-gonzález M pilar Martínez-Montiel Servicio de Aparato Digestivo Hospital 12 de OctubreAvda. de Córdoba28041 MadridSpain

Inflammatory bowel diseases are inflammatory, chronic and progressive diseases of the intestinal tract for which no curative treatment is available. Research in other fields with stem cells of different sources and with immunoregulatory cells(regulatory T-lymphocytes and dendritic T-cells) opens up new expectations for their use in these diseases. The goal for stem cell-based therapy is to provide a permanent cure. To achieve this, it will be necessary to obtain a cellular product, original or genetically modified, that has a high migration capacity and homes into the intestine, has high survival after transplantation, regulates the immune reaction while not being visible to the patient's immune system, and repairs the injured tissue.

关键词： Mesenchymal stem cell Hematopoieticstem cell Inflammatory bowel disease Crohn's disease Ulcerative colitis Amniotic fluid stem cells Inducedpluripotent stem cells Intestinal stem cells Endothelialprogenitor cells Tolerogenic immune cell therapies

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Medicinal plants and natural products as neuroprotective agents in age-related macular degeneration

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Neural Regeneration Research 2020年第12期15卷 2207-2216页

作者： Francisco Bosch-Morell Victoria Villagrasa Teresa Ortega Nuria Acero Dolores Muñoz-Mingarro MEugenia gonzález-Rosende Encarna Castillo MAmparo Sanahuja pilar Soriano Isabel Martínez-Solís Biomedical Sciences Institute Universidad Cardenal Herrera-CEUCEU UniversitiesAlfara del PatriarcaValenciaSpain Department of Biomedical Sciences Faculty of Health SciencesUniversidad Cardenal Herrera-CEUCEU UniversitiesAlfara del PatriarcaValenciaSpain Department of Pharmacy Faculty of Health SciencesUniversidad Cardenal Herrera-CEUCEU UniversitiesAlfara del PatriarcaValenciaSpain Department of Pharmacology Pharmacognosy and BotanyUniversidad Complutense de MadridMadridSpain Department of Pharmaceutical and Health Sciences Faculty of PharmacyUniversidad San Pablo-CEUCEU UniversitiesMadridSpain Department of Chemistry and Biochemistry Faculty of PharmacyUniversidad San Pablo-CEUCEU UniversitiesMadridSpain ICBiBE-Botanical Garden University of ValenciaValenciaSpain

The retina may suffer neurodegenerative damages,as other tissues of the central nervous system do,and serious eye diseases may *** of them is age-related macular degeneration,which causes progressive loss of vision due to retina *** of age-related macular degeneration focuses on antioxidant agents and anti-vascular endothelial growth factor compounds,among others,that prevent/diminish oxidative stress and reduce neovascularisation *** phytochemicals,medicinal plants and/or plant-diet supplements might be a useful adjunct in prevention or treatment of age-related macular degeneration owing to their antioxidant and anti-vascular endothelial growth factor *** review article presents the most investigated plants and natural products in relation to age-related macular degeneration,such as saffron,ginkgo,bilberry and blueberry,curcuma or turmeric,carotenoids,polyphenols,and vitamins C and *** study provides up-to-date information on the effects,treatments,safety and efficiency of these phytotherapy products.

关键词： age-related macular degeneration bilberry blueberry curcuma carotenoids ginkgo polyphenols saffron vitamins

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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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Isotopic niche provides an insight into the ecology of a symbiont during its geographic expansion

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Current Zoology 2022年第2期68卷 185-197页

作者： Enrique gonzAlez-ORTEGON Marta PEREZ-MIGUEL Jose I.NAVAS pilar DRAKE Jose A.CUESTA Instituto de Ciencias Marinas de Andalucia(ICMAN-CSIC) Campus Universitario Rio San PedroAvda.Republica Saharaui211519CadizPuerto RealSpain Unidad Asociada Crecimiento Azul CSIC-IFAPA El Puerto de Santa Maria SpainSpain Instituto de Investigacion y Formacion Agraria y Pesquera IFAPA-Centro Agua del PinoCtra.EI Rompido-Punta Umbriakm 3.821459 EI RompidoHuelvaSpain

The study of the recent colonization of a symbiont and its interaction with host communities in new locations is an opportunity to understand how they *** use of isotopic ratios in trophic ecology can provide measurements of a species'isotopic niche,as well as knowledge about how the isotopic niches between symbiont and host species *** isotope measurements were used to assess the sources of carbon assimilated by the host species(the bivalves Mytilus galloprovincialis and Scrobicularia plana)and their associated symbiont pea crab Afropinnotheres monodi,which occurs within these bivalves'mantle *** mixing model estimates suggest that all of them assimilate carbon from similar sources,particularly from pseudofaeces and particulate organic matter in this symbiotic system based on filter *** symbiotic species occupy comparable trophic levels and its association seems to be commensal or parasitic depending on the duration of such *** pea crab *** reflects a sex-specific diet,where males are more generalist than the soft females because the latter's habitat is restricted to the host *** high isotopic overlap between soft females and *** may reflect a good commensal relationship with the host.

关键词： bivalves commensal kleptoparasitism parasitism stable isotope trophic position

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Pollen Findings in a Presumptive Drowning Case

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Forensic Medicine and Anatomy Research 2015年第2期3卷 43-47页

作者： pilar Martínez Amelia gonzález-Porto Manuel Munuera Natalia Acevedo Biology Service National Institute of Toxicology & Forensic Science Madrid Spain Beekeeping Centre Marchamalo Agrarian Centre Guadalajara Spain Department of Agricultural Science Technology Botanic Area Higher Technical School of Agricultural Engineering Cartagena Spain Institute of Legal Medicine Toledo Spain

A medicolegal/botanical collaboration has to lead to an interdisciplinary procedure for developing methods when studying dead bodies found in water with no clear circumstances. Hereby we present a report or a preliminary attempt as a basis for encouraging further work in the field. The body of an unidentified 25 - 35 years old woman was found immersed in a fresh water ditch in state of decomposition. Structural alterations avoid any a priori identification of asphyxia or traumatic cervical lesions. The last cause of death was estimated as a cardio respiratory collapse and a drowning investigation was proposed. Taxonomic species identification was carried out to relate the pollen aspiration with the water medium in lung, spleen, liver and water medium. We presented pollen grains in spleen, as a closed organ, as a clue for death investigation in the absence of diatom findings. Information about where and when pollen grains occur may ascertain that a body or an object was in some place at a certain time. Since the consequences of aspiration depend on many factors, such as the quantity, size and solidity of the material aspirated and whether the aspiration is chronically recurrent or acute, the pollen investigation must be done with precaution. We conclude that in the absence of other microscopic structures, biochemical blood analyses, or histological findings, forensic palynology may be of help to relate the presumptive drowned body with its death scenario.

关键词： Pollen Grains Drowning Palynology Immersion Diatoms

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