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Diarrhea after bariatric procedures:Diagnosis and therapy

World Journal of Gastroenterology 2017年第26期23卷 4689-4700页

作者： Yves M Borbély Alice Osterwalder Dino Kroll Philipp C Nett roman A Inglin Clinic for visceral Surgery and Medicine InselspitalBern University HospitalUniversity of Bern

Diarrhea after bariatric procedures, mainly those with malabsorptive elements including Roux-Y Gastric Bypass and Biliopancreatic Diversion, is common and an essential determinant of quality of life and microand macronutrient deficiencies. Bariatric surgery is the only sustainably successful method to address morbid obesity and its comorbidities, particularly gaining more and more importance in the specific treatment of diabetic patients. Approximately half a million procedures are annually performed around the world, with numbers expected to rise drastically in the near future. A multitude of factors exert their influence on bowel habits; preoperative comorbidities and procedure-related aspects are intertwined with postoperative nutritional habits. Diagnosis may be challenging owing to the characteristics of postbariatric surgery anatomy with hindered accessibility of excluded segments of the small bowel and restriction at the gastric level. Conventional testing measures, if available, generally yield low accuracy and are usually not validated in this specific population. Limited trials of empiric treatment are a practical alternative and oftentimes an indispensable part of the diagnostic process. This review provides an overview of causes for chronic post-bariatric surgery diarrhea and details the particularities of its diagnosis and treatment in this specific patient population. Topics of current interest such as the impact of gut microbiota and the influence of bile acids on morbid obesity and especially their role in diarrhea are highlighted in order to provide a better understanding of the specific problems and chances of future treatment in post-bariatric surgery patients.

关键词： Bariatric surgery Diarrhea Malnutrition Malabsorption Steatorrhea Dumping syndrome Bile acids and salts Gut microbiota Blind loop syndrome

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Empty nose syndrome pathogenesis and cell-based biotechnology products as a new option for treatment

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World Journal of Stem Cells 2021年第9期13卷 1293-1306页

作者： Inna M Gordiienko Olga S Gubar roman Sulik Taras Kunakh Igor Zlatskiy Alona Zlatska Biotechnology Laboratory Medical Company“Good Cells”Kyiv 03115Ukraine R.E.Kavetsky Institute of Experimental Pathology Oncology and Radiobiology NAS of UkraineKyiv 03022Ukraine Institute of Molecular Biology and Genetics NAS of Ukraine Kyiv 03143Ukraine State Institute of Genetic and Regenerative Medicine National Academy of Medical Sciences of UkraineKyiv 04114Ukraine

Empty nose syndrome (ENS) is a rare complication that develops after partial orcomplete turbinectomy. The main feature of ENS is paradoxical nasal obstructionfeeling despite objectively wide nasal airway. ENS pathogenesis is multifactorialand includes changes in laminar physiological airflow, disruption of mucosafunctions and deficient neural sensation. This leads to the development of ENSsymptomatology such as dyspnea, nasal dryness, nasal burning, nasalobstruction, feeling of suffocation and even comorbid psychiatric disorders thatsignificantly impairs life quality. Specific effective treatment of ENS does not existup to date. In this review we outline existing biomaterial for surgical reconstitutionof nasal anatomy and discuss the perspective of stem cell-based technologiesin ENS management. The main focus is directed to justification ofrationality application of adult mesenchymal stem cells (MSCs) from differenttissues origin and neural crest-derived stem cells (NCSCs) based on their intrinsicbiological properties. MSCs transplantation may stimulate mucosa tissueregeneration via trophic factors secretion, direct transdifferentiation into epithelialcells and pronounced immunosuppressive effect. From the other hand, NCSCsbased on their high neuroprotective properties may reconstitute nerve structureand functioning leading to normal sensation in ENS patients. We postulate thatapplication of cell-based and tissue-engineered products can help to significantlyimprove ENS symptomatology only as complex approach aimed at reconstitutionof nasal anatomy, recovery the nasal mucosa functionality and neural tissuesensation.

关键词： Empty nose syndrome Stem-cell-based technologies Implants biomaterials Grafts Hydrogels Mesenchymal stem cells

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Anticancer actions of PPARγ ligands:Current state and future perspectives in human lung cancer

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World Journal of Biological Chemistry 2010年第3期1卷 31-40页

作者： Jesse roman Division of Pulmonary Critical Care and Sleep Disorders MedicineDepartment of Medicine University of Louisville School of Medicine Louisville veterans Affairs Medical Center

Peroxisome proliferator-activated receptors(PPARs) are ligand-dependent nuclear transcription factors and members of the nuclear receptor *** the three PPARs identified to date(PPARγ,PPARβ/δ,and PPARα),PPARγ has been studied the most,in part because of the availability of PPARγagonists(also known as PPARγ ligands)and its significant effects on the management of several human diseases including type 2 diabetes,metabolic syndrome,cardiovascular disease and ***γ is expressed in many tumors including lung cancer,and its function has been linked to the process of lung cancer development, progression and *** performed in gynogenic and xenograft models of lung cancer showed decreased tumor growth and metastasis in animals treated with PPARγ ***,data are emerging from retrospective clinical studies that suggest a protective role for PPARγ ligands on the incidence of lung *** review summarizes the research being conducted in this area and focuses on the mechanisms and potential therapeutic effects of PPARγ ligands as a novel anti-lung cancer treatment strategy.

关键词： Gene expression and regulation Human lung cancer Ligands Peroxisome proliferator-activated receptorγ Signaling pathways Therapy

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Perioperative coagulation activation after permanent pacemaker placement

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World Journal of Cardiology 2023年第4期15卷 174-183页

作者： roman Kalinin Igor Suchkov vladislav Povarov Nina Mzhavanadze Olga Zhurina Department of Cardiovascular Endovascular Surgery and Diagnostic RadiologyRyazan State Medical UniversityRyazan 390026Russia Department of Surgical Treatment of Cardiac Arrhythmias and Cardiac Pacing Ryazan State"Regional Clinical Cardiology Dispensary"Ryazan 390026Russia Scientific and Clinical Center for Hematology Oncology and ImmunologyRyazan State Medical UniversityRyazan 390026Russia

BACKGROUND Bradyarrhythmias are typically treated with permanent pacemakers(PM). The elimination of bradyarrhythmia by PM implantation improves the patient’s quality of life and prognosis, but it can also result in a number of sequalae. It is still unclear how PM implantation affects the hemostasis system’s parameters and how such parameters relate to different consequences after PM *** To assess the blood coagulation factor activity in PM patients throughout the perioperative *** Patients treated in the Department of Surgical Therapy of Cardiac Arrhythmias and Pacing at the Ryazan State "Regional Clinical Cardiology Dispensary" from April 2020 to December 2021 were included in the study. Before surgery, 7 and 30 d after PM placement, peripheral venous blood samples were withdrawn to measure the level of blood coagulation factor Ⅰ(FⅠ) and the activity of blood coagulation factors Ⅱ(FⅡ), Ⅴ(FⅤ), Ⅶ(FⅦ), Ⅷ(FⅧ), ⅸ(Fⅸ), ⅹ(Fⅹ), Ⅺ(FⅪ), Ⅻ(FⅫ). We used an automatic coagulometer Sysmex CA 660(Sysmex Europe, Germany) and reagents from Siemens(Siemens Healthcare Diagnostics Products GmbH, Germany).RESULTS The study included 146 patients. The activity of factors FⅤ [147.7(102.1-247.55)% vs 103.85(60-161.6)% vs 81.8(67.15-130.65)%, P = 0.002], FⅧ [80.4(60.15-106.25)% vs 70.3(48.5-89.1)% vs 63.7(41.6-88.25)%, P = 0.039], Fⅸ [86.2(70.75-102.95)% vs 75.4(59.2-88.3)% vs 73.9(56.45-93.05)%, P = 0.014], Fⅹ [188.9(99.3-308.18)% vs 158.9(83.3-230)% vs 127.2(95.25-209.35)%, P = 0.022], FⅪ [82.6(63.9-103.6)% vs 69.75(53.8-97.6)% vs 67.3(54.25-98.05)%, P = 0.002], FⅫ [87.6(67.15-102.3)% vs 78.9(63.4-97.05)% vs 81.2(62.15-97.4)%, P vity [157.9(109.7-245.25)% vs 130(86.8-192.5)% vs 144.8(103.31-185.6)%, P = 0.021] decreased at 7 d and increased at 30 d postoperatively. There were no statistically significant changes in the FvII activity within 30 d after PM placement [182.2(85.1-344.8)% vs 157.2(99.1-259)% vs 108.9(74.9

关键词： Hemostasis Blood coagulation Cardiac pacemaker Anticoagulants Postoperative complications

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Probiotics in hepatology:An update

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World Journal of Hepatology 2021年第9期13卷 1154-1166页

作者： roman Maslennikov vladimir Ivashkin Irina Efremova Elena Poluektova Elena Shirokova Department of Internal Medicine Gastroenterology and HepatologySechenov UniversityMoscow 119435Russia Scientific Community for Human Microbiome Research Moscow 119435Russia Department of Internal Medicine Consultative and Diagnostic Center of the Moscow City Health DepartmentMoscow 107564Russia

The gut-liver axis plays an important role in the pathogenesis of various liver *** are living bacteria that may be used to correct disorders of this *** progress has been made in the study of probiotic drugs for the treatment of various liver diseases in the last *** has been proven that probiotics are useful for hepatic encephalopathy,but their effects on other symptoms and syndromes of cirrhosis are poorly *** effectiveness in the treatment of metabolic associated fatty liver disease has been shown both in experimental models and in clinical trials,but their effect on the prognosis of this disease has not been *** beneficial effects of probiotics in alcoholic liver disease have been shown in many experimental studies,but there are very few clinical trials to support these *** effects of probiotics on the course of other liver diseases are either poorly studied(such as primary sclerosing cholangitis,chronic hepatitis B and C,and autoimmune hepatitis)or not studied at all(such as primary biliary cholangitis,hepatitis A and E,Wilson's disease,hemochromatosis,storage diseases,and vascular liver diseases).Thus,despite the progress in the study of probiotics in hepatology over the past decade,there are many unexplored and unclear questions surrounding this topic.

关键词： Gut-liver axis Pathogenesis Gut dysbiosis Gut microbiota Gut microbiome Liver disease Probiotics Hepatic encephalopathy Cirrhosis Metabolic associated fatty liver disease Alcoholic liver disease Primary sclerosing cholangitis

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Genomic medicine in gastroenterology:A new approach or a new specialty?

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World Journal of Gastroenterology 2015年第27期21卷 8227-8237页

作者： Sonia roman Arturo Panduro Department of Molecular Biology in Medicine Civil Hospital of Guadalajara "Fray Antonio Alcalde" Mexico and Health Sciences Center University of Guadalajara

Throughout history, many medical milestones have been achieved to prevent and treat human ***'s early conception of illness was naturally holistic or integrative. However, scientific knowledge was atomized into quantitative and qualitative research. In the field of medicine, the main trade-off was the creation of many medical specialties that commonly treat patients in advanced stages of disease. However, now that we are immersed in the post-genomic era, how should we reevaluate medicine? Genomic medicine has evoked a medical paradigm shift based on the plausibility to predict the genetic susceptibility to disease. Additionally, the development of chronic diseases should be viewed as a continuum of interactions between the individual's genetic make-up and environmental factors such as diet, physical activity, and emotions. Thus, personalized medicine is aimed at preventing or reversing clinical symptoms, and providing a better quality of life by integrating the genetic, environmental and cultural factors of diseases. Whether using genomic medicine in the field of gastroenterology is a new approach or a new medical specialty remains an open question. To address this issue, it will require the mutual work of educational and governmental authorities with public health professionals, with the goal of translating genomic medicine into better health policies.

关键词： Chronic diseases Nutritional genomics Obesity Liver disease Gastrointestinal diseases

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Immunologic, metabolic and genetic factors in hepatitis C virus infection

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World Journal of Gastroenterology 2014年第13期20卷 3443-3456页

作者： Nora A Fierro Karina Gonzalez-Aldaco Rafael Torres-valadez Erika Martinez-Lopez Sonia roman Arturo Panduro Department of Molecular Biology in Medicine Civil Hospital of Guadalajara"Fray Antonio Alcalde" and Health Sciences CenterUniversity of GuadalajaraGuadalajara 44280JaliscoMexico

The mechanisms that regulate disease progression during hepatitis C virus(HCv)infection and the response to treatment are not clearly *** studies have demonstrated that a strong host immune response against HCv favors HCv *** addition,genetic factors and metabolic machinery,particularly cholesterol modulation,are involved in HCv *** is likely that the interplay between all of these factors contributes to the outcome of HCv *** recent years,the world has experienced its largest epidemic of *** and the United States are the leading sufferers from this epidemic at the global *** is associated with the development ofnumerous pathologies including hypercholesterolemia which is one of the eight most important risk factors for mortality in *** may be related to the course of HCv infection in this ***,we focus on the urgent need to study the progression of HCv infection in relation to ethnic *** are discussed that hold promise in identifying immune,metabolic and genetic factors that,in conjunction,could be therapeutic targets or predictors of the progression of HCv infection.

关键词： Hepatitis C virus Immune response Lipids Metabolism Genetics

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Gastrointestinal manifestations of endocrine disease

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World Journal of Gastroenterology 2006年第20期12卷 3174-3179页

作者： Christina Maser Arnbjorn Toset Sanziana roman Department of Surgery Yale University School of Medicine 333 Cedar StreetNew Haven CT 06520United States

The hormonal interactions among the systems throughout the body are not fully understood; many vague clinical symptoms may in fact be manifestations of underlying endocrine diseases. The aim of the following review is to discuss gastrointestinal manifestations of surgically correctable endocrine diseases, focusing on abnormalities of thyroid function, cancer and finally autoimmune diseases. We also review manifestations of pancreatic endocrine tumors, and multiple endocrine neoplasia.

关键词： Functional thyroid disease Autoimmunethyroid disease Thyroid malignancy Islet cell tumors

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Diagnostic and treatment utility of echocardiography in the management of the cardiac patient

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World Journal of Cardiology 2020年第6期12卷 262-268页

作者： Ariella Khalili Jennifer Drummond Neiman Ramjattan roman Zeltser Amgad N Makaryus North Shore Hebrew Academy Great NeckNY 11020United States Department of Internal Medicine Tufts Medical CenterBostonMA 10211United States Department of Cardiology Nassau University Medical CenterEast MeadowNY 11554United States Department of Cardiology Donald and Barbara Zucker School of Medicine at Hofstra/NorthwellHempsteadNY 11549United States

BACKGROUND Echocardiograms are an incredibly useful diagnostic tool due to their lack of harmful radiation,the relative ease and speed with which they can be performed,and their almost ubiquitous ***,the advantages that support the use of echocardiography can also lead to the overuse of this *** sought to evaluate the physician perceived impact echocardiography has on patient *** To evaluate the physician perceived impact echocardiography has on patient *** Surveys were distributed to the ordering physician for echocardiograms performed at our institution over a 10-wk *** transthoracic echocardiograms performed on the inpatient service were *** were distributed to either the attending physician or the resident physician listed on the echocardiogram *** information requested in the survey focused on the indication for the study and the perceived importance and effect of the *** statistical analysis was performed on all of the answers from the collected *** A total of 103 surveys were obtained and *** internal medicine(57%)and cardiology(37%)specialties ordered the most *** most common reason for ordering an echocardiogram was to rule out a diagnosis(38.2%).Only 27.5%of physicians reported that the echocardiogram significantly affected patient care,with 18.6%reporting a moderate effect,and 30.4%reporting a mild effect.A total of 19.6%of physicians stated that there was no effect on patient ***,43.1%of physicians reported that they made changes in patient management due to no change having occurred in the disease,11.8%reported that changes in management were based on the recommendation of a specialist,and only 9.8%reported that further imaging was ordered due to the results of the *** majority of physicians(67.6%)considered an echocardiogram to be“somewhat essential”in the management of adult inpat

关键词： Echocardiogram Utilization Cardiology Inpatient Survey Management

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Improving the performance of LOX/kerosene upper stage rocket engines

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Propulsion and Power Research 2017年第3期6卷 157-176页

作者： Igor N.Nikischenko Raymond D.Wright roman A.Marchan Firefly Europe B.v. Blaricum 1261 GAThe Netherlands Spacefleet Ltd DevizesWiltshireSN103APUnited Kingdom

Improved liquid rocket engine cycles were proposed and analyzed via comparison with existing staged combustion and gas-generator *** key features of the proposed cycles are regenerative cooling of thrust chamber by oxygen and subsequent use of this oxygen for driving one or two oxygen *** fuel pump(s)are driven in a conventional manner,for example,using a fuel-rich gas-generator *** with staged combustion cycle based on oxygen-rich pre-burner showed that one of the proposed semi-expander cycles has a specific impulse only on 0.4%lower while providing much lower oxygen temperature,more efficient tank pressurizing system and built-in roll *** semi-expander cycle can be considered as a more reliable and cost-effective alternative of staged combustion *** semi-expander cycle can be considered as an improvement of gas-generator *** proposed semi-expander cycles were developed as a derivative of thrust chamber regenerative cooling performed by *** of existing oxygen/kerosene engines showed that replacing of kerosene regenerative cooling with oxygen allows a significant increase of achievable specific impulse,via optimization of mixture *** is especially the case for upper stage *** increasing of propellants average density can be considered as an additional benefit of mixture ratio *** was demonstrated that oxygen regenerative cooling of thrust chamber is a feasible and the most promising option for oxygen/kerosene *** of oxygen regenerative cooling and semi-expander cycles potentially allows creating the oxygen/kerosene propulsion systems with minimum specific impulse *** is important that such propulsion systems can be fully based on inherited and well-proven technical solutions.A hypothetic upper stage engine with thrust 19.6 kN was chosen as a prospective candidate for theoretical analysis of the proposed semi-expander *** newly-developed software RECS

关键词： Oxygen Kerosene Liquid rocket engine Upper stage

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