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

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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Comparison of Chemical and Functional Properties of Stevia rebaudiana(Bertoni)Varieties Cultivated in Mexican Southeast

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American Journal of Plant Sciences 2014年第3期5卷 286-293页

作者： Maira Segura-Campos Enrique Barbosa-martín Angel Matus-Basto Diana Cabrera-Amaro María Murguía-olmedo Yolanda Moguel-Ordonez David Betancur-Ancona Facultad de Ingeniería Química Universidad Autónoma de YucatánYucatanMexico Instituto nacional de Invesigaciones Forestales Agrícolas y Pecuarias(INIFAP)YucatanMexico

The leaf powders from two varieties of Stevia rebaudiana (Bertoni) cultivated in Yucatan, Mexico were analyzed for their proximate composition, dietary fiber composition and functional properties. The leaf powders were a good source of carbohydrates (64.06%-67.98%), protein (12.11%-15.05%), and crudefiber (5.92%-9.52%). Total dietary fiber content in the S. rebaudiana leaf powders were 28.61 (Morita II) and 29.12 (Criolla) g/100g sample, with most of this content represented by insoluble dietary fiber 87.79% (Morita II) and 70.02% (Criolla). neutral detergent fiber (nDF), acid detergent fiber (ADF) and acid detergent lignin (ADl) were higher in Criolla (19.29%, 17.77%, 8.98%) than Morita II variety (18.11%, 14.16%, 2.28%). Hemicellulose and cellulose were higher in Morita II (3.96%, 11.78%) than criolla variety (1.51%, 8.79%). Functional properties of leaf powder from Morita II and Criolla were, water-holding capacity (2.87-4.07 g/g sample), oil-holding capacity (6.49-6.79 g/g sample), water-absorption capacity (3.41-3.44 g/g sample), water-adsorption capacity (0.25-0.28 g/g sample), and organic molecule absorption capacity (1.13-1.81 g/g sample). These suggest that S. rebaudiana (Bertoni) leaf powders may be used as dietary supplement or as food additive.

关键词： Stevia rebaudiana(Bertoni) Physico-Chemical Properties Dietary Fiber Functional Properties

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Diabetes and Periodontal Diseases: An Established Two-Way Relationship

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Journal of Diabetes Mellitus 2016年第4期6卷 209-229页

作者： Carlos Arana Molina luna Florencio Ojeda María Sevillano Jiménez Cristóbal Morales Portillo Isabel Serrano olmedo Tomás martín Hernández Gerardo Gómez Moreno Department of Endocrinology and nutrition Virgen Macarena University Hospital Seville Spain Department of Special Care in Dentistry Pharmacological Research in Dentistry Group Faculty of Dentistry University of Granada Granada Spain

Background: Periodontal diseases (PD), including periodontitis, are chronic inflammatory pathologies caused by bacteria in the subgingival biofilm which affect the periodontal tissues. PD is now considered a localized, chronic, oral infection that activates the host immuno-inflammatory responses both locally and systemically, and also constitutes a source of bacteraemia. It is a known fact that periodontal diseases exercise an important influence on the pathogenesis of numerous systemic diseases, including diabetes mellitus (DM). In the mid-nineties, sufficient scientific evidence emerged to confirm an association between DM and periodontitis, which then began to be regarded as the sixth complication of DM. Current scientific evidence points to a two-way relationship between DM and periodontal disease, whereby DM is associated with an increase in the incidence and progression of periodontitis, while periodontal infection is associated with worsening glycemic control in diabetic patients. This two-way relationship points to a need to promote oral health in DM patients, and to implement a joint management protocol between endocrinologist and dentist that aims to create adequate conditions for early diagnosis and the effective treatment of both diseases.

关键词： Diabetes Mellitus Periodontitis Periodontal Medicine Two-Way Relationship

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Thyroid nodule: Alpha Score 2.0 Classification for FnAB Selection, Multicentric Study in latin America

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Open Journal of radiology 2021年第4期11卷 160-174页

作者： Glenn Mena Maria Cristina Chammas Carlos Mario Gonzalez Vasquez lylian Rocío Villagómez Marco Alfredo Muñoz Pico Patricio Alejandro Montalvo Santiago Mena-Bucheli Julio olmedo Elizabeth Quintero Pedro Henrique de Marqui Moraes Osmar Cassio Saito Hubertino Diaz Denise Romero Gabriela Velalcazar Angel ramón Sosa Fleitas Yamil Oliver Quevedo Ontaneda Victor Ricardo Chara Alpha Imagen radiología e Intervencionismo Quito Ecuador Hospital das Clínicas Faculdade de Medicina da Universidade de Sã o Paulo S&#227 o Paulo Brasil Hospital Pablo Tobón Uribe Medellin Colombia Hospital del Instituto Ecuatoriano de Seguridad Social Quito Sur Quito Ecuador Hospital San Francisco de Quito Quito Ecuador Hospital Edgardo Rebagliati martins Lima Perú Hospital Carlos Andrade Marín Quito Ecuador Hospital de Clínicas San José de San martín Buenos Aires Argentina Hospital Universitario de los Andes Mérida Venezuela Hospital de la Policía Quito Ecuador Hospital Sisol Tacna Perú

Introduction: To perform a latin-American multicentric study for the prediction of benign and malignant thyroid nodules using Alpha Score, and to compare it with ACR TIraDS® and Bethesda®. Materials and Methods: A pro... 详细信息

ng>Introduction:ng> To perform a latin-American multicentric study for the prediction of benign and malignant thyroid nodules using Alpha Score, and to compare it with ACR TIraDS® and Bethesda®. ng>Materials and Methods:ng> A prospective multicentric study in 10 radiological hospitals and institutions of latin America was performed and 818 thyroid nodules were analyzed by ultrasound and classified by using both ACR TIraDS® and Alpha Score;fine-needle aspiration biopsy was performed when needed and classified with Bethesda. The relationships between predictors were analyzed by using binary logistic regression, statistical significance was defined by a p-value of 0.05, with an error margin of 4% and 95% confidence intervals. ng>Results:ng> Alpha Score 2.0 establishes five types of malignant predictors: microcalcifications, irregular borders, taller-than-wide shape, predominant solid texture and hypoechogenicity;a diameter equal to or greater than 1.5 cm adds an extra point to the final score. Resulting classification divides Tns into 4 categories: benign (1.9%), low suspicion (8.7%), mild suspicion (13.6%) and high suspicion (75.7%) of malignancy probability;sensitivity of 82%, specificity of 74%, the positive predictive value of 94%, the negative predictive value of 51%, the statistical accuracy of 81%, odds ratio of 108.89 and correlation with ACR TIraDS of 0.77 and Bethesda of 0.91.ng> Conclusions: ng>Alpha Score 2.0 has superior diagnostic accuracy and performance compared to the previously published Alpha Score and is able to classify a benign Tn in a precise, safe and accurate way, avoiding unnecessary FnABs or determining the necessity of FnAB in cases of moderate to high suspicion of malignancy.

关键词： Thyroid Cancer-Clinical radiology-Imaging Thyroid nodule Alpha Score TIraDS® Thyroid Ultrasonography

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