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Clinical relevance of clopidogrel-proton pump inhibitors interaction

World Journal of Gastrointestinal Pharmacology and Therapeutics 2015年第2期6卷 17-21页

作者： stella d bouziana Konstantinos Tziomalos First Propedeutic department of Internal Medicine Medical School Aristotle University of Thessaloniki AHEPA Hospital

Clopidogrel is a widely used antiplatelet agent for the secondary prevention of cardiovascular events in patients with stable coronary heart disease, acute coronary syndromes and ischemic stroke. Even though clopidogrel is safer than aspirin in terms of risk for gastrointestinal(GI) bleeding, the elderly, and patients with a history of prior GI bleeding, with Helicobacter pylori infection or those who are also treated with aspirin, anticoagulants, corticosteroids or nonsteroidal antiinflammatory drugs are at high risk for GI complications when treated with clopidogrel. Accordingly, proton pump inhibitors are frequently administered in combination with clopidogrel to reduce the risk for GI bleeding. Nevertheless, pharmacodynamic studies suggest that omeprazole might attenuate the antiplatelet effect of clopidogrel. However, in observational studies, this interaction does not appear to translate into increased cardiovascular risk in patients treated with this combination. Moreover, in the only randomized, double-blind study that assessed the cardiovascular implications of combining clopidogrel and omeprazole, patients treated with clopidogrel/omeprazole combination had reduced risk for GI events and similar risk for cardiovascular events than patients treated with clopidogrel and placebo. However, the premature interruption of the study and the lack of power analysis in terms of the cardiovascular endpoint do not allow definite conclusions regarding the cardiovascular safety of clopidogrel/omeprazole combination. Other proton pump inhibitors do not appear to interact with clopidogrel. Nevertheless, given the limitations of existing observational and interventional studies, the decision to administer proton pump inhibitors to patients treated with clopidogrel should be individualized based on the patient's bleeding and cardiovascular risk.

关键词： Clopidogrel Esomeprazole Lansoprazole Pantoprazole Rabeprazole Omeprazole Cardiovascular risk Proton pump inhibitors

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Inhibition of apoptosis in the management of nonalcoholic fatty liver disease

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World Journal of Gastrointestinal Pharmacology and Therapeutics 2013年第1期4卷 4-8页

作者： stella d bouziana Konstantinos Tziomalos First Propaedeutic department of Internal Medicine Medical School Aristotle University of Thessaloniki AHEPA Hospital 54636 Thessaloniki Greece

Nonalcoholic fatty liver disease (NAFLd) is the leading cause of chronic liver disease in the developed world. The pathogenesis of NAFLd is multifactorial, involving obesity, insulin resistance, inflammation and oxidative stress. Accordingly, several treatments targeting these pathways have been evaluated in patients with NAFLd but have either shown limited efficacy or an unfavorable safety profile. On the other hand, increased hepatocyte apoptosis also appears to be implicated in the development and progression of NAFLd and recent pilot studies suggest that inhibition of apoptosis might represent a useful approach in this disease. However, several issues pertaining both to the efficacy and safety of this new class of agents remain unresolved and larger studies are required to clarify the role of this therapeutic modality in the management of NAFLd.

关键词： Apoptosis Nonalcoholic fatty liver disease Nonalcoholic steatohepatitis Fatty liver Carcinogenesis Cirrhosis Caspase

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在不含酒精的脂肪肝疾病和尖锐 ischemic 击严厉和结果之间的协会

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World Journal of Hepatology 2013年第11期5卷 621-626页

作者： Konstantinos Tziomalos Vasilios Giampatzis stella d bouziana Marianna Spanou Maria Papadopoulou Athinodoros Pavlidis Stavroula Kostaki Andreas Bozikas Christos Savopoulos Apostolos I Hatzitolios First Propedeutic department of Internal Medicine Department of Medicine Aristotle University of Thessaloniki AHEPA Hospital

AIM:To evaluate the association of nonalcoholic fatty liver disease(NAFLd)with acute ischemic stroke severity and in-hospital ***:We prospectively studied all patients who were admitted in our department with acute ischemic stroke between September 2010 and August 2012(n=415;39.5%males,mean age 78.8±6.6 years).The severity of stroke was assessed with the National Institutes of Health Stroke Scale(NIHSS)score at *** was defined as serum alanine aminotransferase and/or aspartate aminotransferase levels above the upper limit of normal in the absence of other causes of elevated aminotransferases levels[chronic hepatitis B or C,drug toxicity,increased alcohol consumption(>21 and>14 drinks per week in men and women,respectively),cholestatic diseases or rhabdomyolysis].The outcome was assessed with the modified Rankin scale(mRS)score at discharge and in-hospital *** outcome was defined as mRS score at discharge≥*** at discharge was defined as mRS score between 2 to ***:NAFLd was present in 7.7%of the study *** with NAFLd had lower serum high-density lipoprotein cholesterol and higher triglyceride levels than patients without NAFLd(Pdemographic data,the prevalence of other cardiovascular risk factors and the prevalence of established CVd did not differ between the two *** admission,the NIHSS score did not differ between patients with and without NAFLd(6.3±6.4and 8.8±9.6,respectively;P=NS).At discharge,the mRS score did not differ between the two groups(1.9±2.2 and 2.6±2.2 in patients with and without NAFLd,respectively;P=NS).Rates of dependency at discharge were also similar in patients with and without NAFLd(36.8%and 55.0%,respectively;P=NS)as were the rates of adverse outcome(42.9%and58.6%,respectively;P=NS).In-hospital mortality rates also did not differ between the 2 groups(8.0%and 7.0%in patients with and without NAFLd,respectively;P=NS).CONCLUSION:The presen

关键词： Nonalcoholic fatty liver disease Stroke Outcome Aminotransferases γ-glutamyl transpeptidase Cardiovascular disease Type 2 diabetes mellitus Obesity Cardiovascular risk

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Type 2 diabetes is associated with a worse functional outcome of ischemic stroke

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World Journal of diabetes 2014年第6期5卷 939-944页

作者： Konstantinos Tziomalos Marianna Spanou stella d bouziana Maria Papadopoulou Vasilios Giampatzis Stavroula Kostaki Vasiliki dourliou Maria Tsopozidi Christos Savopoulos Apostolos I Hatzitolios First Propedeutic department of Internal Medicine Medical SchoolAristotle University of ThessalonikiAHEPA Hospital

AIM: To assess whether ischemic stroke severity and outcome is more adverse in patients with type 2 diabetes mellitus(T2dM). METHOdS: Consecutive patients hospitalized for acute ischemic stroke between September 2010 and June 2013 were studied prospectively(n = 482; 40.2% males, age 78.8 ± 6.7 years). T2 dM was defined as self-reported T2 dM or antidiabetic treatment. Stroke severity was evaluated with the National Institutes of Health Stroke Scale(NIHSS) score at admission. The outcome was assessed with the modified Rankin scale(m RS) score at discharge and with in-hospital mortality. Adverse outcome was defined as m RS score at discharge ≥ 2 or in-hospital death. The length of hospitalization was also ***: T2 dM was present in 32.2% of the study population. Patients with T2 dM had a larger waist circumference, higher serum triglyceride and glucose levels and lower serum high-density lipoprotein cholesterol levels as well as higher prevalence of hypertension, coronary heart disease and congestive heart failure than patients without T2 dM. On the other hand, diabetic patients had lower low-density lipoprotein cholesterol levels and reported smaller consumption of alcohol than non-diabetic patients. At admission, the NIHSS score did not differ between patients with and without T2dM(8.7 ± 8.8 and 8.6 ± 9.2, respectively; P = NS). At discharge, the m RS score also did not differ between the two groups(2.7 ± 2.1 and 2.7 ± 2.2 in patients with and without T2 dM, respectively; P = NS). Rates of adverse outcome were also similar in patients with and without T2dM(62.3% and 58.5%, respectively; P = NS). However, when we adjusted for the differences between patients with T2 dM and those without T2 dM in cardiovascular risk factors, T2 dM was independently associated with adverse outcome [relative risk(RR) = 2.39; 95%CI: 1.21-4.72, P = 0.012]. Inhospital mortality rates did not differ between patients with T2 dM and those without T2dM(9.0% and 9.8%, respectively;

关键词： worse severity admission cardiovascular NIHSS independently prevalence multivariate triglyceride mortality

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Multivariate Approach to Characterizing Soil Quality of Gabonese’s Ferralitic Soils

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Open Journal of Soil Science 2024年第4期14卷 237-268页

作者： Neil-Yohan Musadji Rolf Gaël Mabicka Obame Michel Mbina Mounguengui Jean Aubin Ondo Lydie-stella Koutika Eric Ravire Claude Geffroy Laboratoire de Chimie Des Milieux et Des Mat&#233riaux Inorganiques Laboratoire D&#8217Analyse Des Sols et Environnement D&#233partement Des Sciences Fondamentales De L&#8217Ing&#233nieur Institut National D&#8217Agronomie et De Biotechnologies Universit&#233 Des Sciences et Techniques De Masuku Franceville Gabon Institut de Chimie des Milieux et Maté riaux De Poitiers (IC2MP) Universit&#233 De Poitiers Poitiers France Laboratoire de Chimie Des Milieux et Des Mat&#233riaux Inorganiques Laboratoire D&#8217Analyse Des Sols et Environnement D&#233partement De Phytotechnologie Institut National D&#8217Agronomie et De Biotechnologies Universit&#233 Des Sciences et Techniques De Masuku Franceville Gabon dé partement De G&#233ologie Facult&#233 Des Sciences Universit&#233 Des Sciences et Techniques De Masuku Franceville Gabon Laboratoire Pluridisciplinaire des Sciences Ecole Normale Sup&#233rieure Libreville Gabon Centre de Recherche Sur La Productivité et La Durabilit&#233 Des Plantations Industrielles Pointe Noire Republic of Congo Sucaf Gabon Somdiaa Franceville Gabon

Assessing soil quality is essential for crop management and soil temporal changes. The present study aims to evaluate soil quality in the Ferralitic soils context countrywide. This assessment was done using multivariate soil quality indice (SQI) models, such as additive quality index (AQI), weighted quality indexes (WQIadd and WQIcom) and Nemoro quality index (NQI), applied to two approaches of indicator selection: total data set (TdS) and minimum data set (MdS). Physical and chemical soil indicators were extracted from the ORSTOM’s reports resulting from a sampling campaign in different provinces of Gabon. The TdS approach shows soil quality status according to eleven soil indicators extracted from the analysis of 1,059 samples from arable soil layer (0 - 30 cm depth). The results indicated that 87% of all provinces presented a very low soil quality (Q5) whatever the model. Among soil indicators, exchangeable K+ and Mg2+, bulk density and C/N ratio were retained in MdS, using principal component analysis (PCA). In the MdS approach, 50 to 63% of provinces had low soil quality grades with AQI, WQIadd and NQI, whereas the total was observed with WQIcom. Only 25% of provinces had medium soil quality grades with AQI and NQI models, while 12.5% (NQI) and 25% (AQI) presented high quality grades. Robust statistical analyses confirmed the accuracy and validation (0.80 r P ≤ 0.016) of AQI, WQIadd and NQI into the TdS and MdS approaches. The same sensitivity index value (1.53) was obtained with AQI and WQIadd. However, WQIadd was chosen as the best SQI model, according to its high linear regression value (R2 = 0.82) between TdS and MdS. This study has important implications in decision-making on monitoring, evaluation and sustainable management of Gabonese soils in a pedoclimatic context unfavorable to plant growth.

关键词： Gabon Ferralitic Soil Soil Indicators Standard Score Function Soil Quality Indices Sustainable Soil Soil Management

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This pain drives me crazy:Psychiatric symptoms in women with interstitial cystitis/bladder pain syndrome

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World Journal of Psychiatry 2024年第6期14卷 954-984页

作者： Marianna Mazza stella Margoni Giuseppe Mandracchia Guglielmo donofrio Alessia Fischetti Georgios d Kotzalidis Giuseppe Marano Alessio Simonetti delfina Janiri Lorenzo Moccia Ilaria Marcelli Greta Sfratta domenico de Berardis Ottavia Ferrara Evelina Bernardi Antonio Restaino Francesco Maria Lisci Antonio Maria d'Onofrio Caterina Brisi Flavia Grisoni Claudia Calderoni Michele Ciliberto Andrea Brugnami Sara Rossi Maria Chiara Spera Valeria de Masi Ester Maria Marzo Francesca Abate Gianluca Boggio Maria Benedetta Anesini Cecilia Falsini Anna Quintano Alberto Torresi Miriam Militenda Giovanni Bartolucci Marco Biscosi Sara Ruggiero Luca Lo Giudice Giulia Mastroeni Elisabetta Benini Luca di Benedetto Romina Caso Francesco Pesaresi Francesco Traccis Luca Onori Luca Chisari Leonardo Monacelli Mariateresa Acanfora Eleonora Gaetani Monia Marturano Sara Barbonetti Elettra Specogna Francesca Bardi Emanuela de Chiara Gianmarco stella Andrea Zanzarri Flavio Tavoletta Arianna Crupi Giulia Battisti Laura Monti Giovanni Camardese daniela Chieffo Antonio Gasbarrini Giovanni Scambia Gabriele Sani department of Neurosciences Fondazione Policlinico Universitario A Gemelli IRCCSUniversita Cattolica del Sacro CuoreRome 00168Italy department of Psychiatry UniversitàCattolica del Sacro CuoreRome 00168Italy department of Neurosciences Section of PsychiatryFondazione Policlinico Universitario Agostino Gemelli IRCCSUniversitàCattolica del Sacro CuoreRome 00168Italy Mental Health NHSASL 4 TeramoTeramo 64100Italy Medical and Surgical Sciences UniversitàCattolica del Sacro CuoreRome 00168Italy division of Gynecologic Oncology UniversitàCattolica del Sacro CuoreRome 00168Italy UOS Psicologia Clinica Governo ClinicoFondazione Policlinico Universitario Agostino Gemelli IRCCSRome 00168Italy CEMAd digestive disease Center Fondazione Policlinico Universitario A.Gemelli-IRCCSRome 00168Italy department of Woman and Child Health Catholic UniversityRome 00168Italy UOC Psichiatria Clinica e d’Urgenza Dipartimento di Scienze Dell’InvecchiamentoNeurologicheOrtopediche e Della Testa-colloFondazione Policlinico Universitario Agostino Gemelli IRCCSRome 00168Italy

BACKGROUNd Interstitial cystitis/bladder pain syndrome(IC/BPS)is an at least 6-mo noninfectious bladder inflammation of unknown origin characterized by chronic suprapubic,abdominal,and/or pelvic *** the term cystitis suggests an inflammatory or infectious origin,no definite cause has been *** occurs in both sexes,but women are twice as much *** To systematically review evidence of psychiatric/psychological changes in persons with IC/*** Hypothesizing that particular psychological characteristics could underpin IC/BPS,we investigated in three databases the presence of psychiatric symptoms and/or disorders and/or psychological characteristics in patients with IC/BPS using the following strategy:("interstitial cystitis"OR"bladder pain syndrome")ANd("mood disorder"OR depressive OR antidepressant OR depression OR depressed OR hyperthymic OR mania OR manic OR rapid cyclasterisk OR dysthymiasterisk OR dysphoriasterisk).RESULTS On September 27,2023,the PubMed search produced 223 articles,CINAHL 62,and the combined PsycLIT/PsycARTICLES/PsycINFO/Psychology and Behavioral Sciences Collection search *** on *** produced 14 studies,of which none had available *** were peer-reviewed articles reporting psychiatric/psychological symptoms in patients with IC/BPS,i.e.63 articles spanning from 2000 to October *** studies identified depression and anxiety problems in the IC/BPS population,along with sleep problems and the tendency to *** Psychotherapies targeting catastrophizing and life stress emotional awareness and expression reduced perceived pain in women with IC/*** concepts should be considered when implementing treatments aimed at reducing IC/BPS-related pain.

关键词： Interstitial cystitis/bladder pain syndrome Psychiatric symptoms Psychological symptoms Catastrophizing Anxiety depression

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National Soil Organic Carbon Stocks Inventories under different Mangrove Forest Types in Gabon

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Open Journal of Forestry 2024年第2期14卷 127-140页

作者： Rolf Gaël Mabicka Obame Neil-Yohan Musadji Jean Hervé Mve Beh Lydie-stella Koutika Jean Aubin Ondo Farrel Nzigou Boucka Michel Mbina Mounguengui Claude Geffroy dé partement de Phytotechnologie Institut National d&#8217Agronomie et de Biotechnologies Universit&#233 des Sciences et Techniques de Masuku Franceville Gabon dé partement des Sciences Fondamentales de l&#8217Ing&#233nieur Institut National d&#8217Agronomie et de Biotechnologies Universit&#233 des Sciences et Techniques de Masuku Franceville Gabon Institut Agronomiques et Forestiè res Centre National des Recherches Scientifiques et Technologiques Libreville Gabon Research Centre on the durability and the Productivity of Industrial Plantations (CRdPI) Pointe Noire Republic of Congo Laboratoire Pluridisciplinaire des Sciences &#201cole Normale Sup&#233rieure Libreville Gabon Agence Gabonaise d’ &#201tude et d&#8217Observation Spatiale Immeuble les Arcades Libreville Gabon dé partement de G&#233ologie Faculte des Sciences Universit&#233 des Sciences et Techniques de Masuku Franceville Gabon Institut de Chimie des Milieux et Maté riaux de Poitiers (IC2MP) Universit&#233 de Poitiers Poitiers France

Gabonese’s estuary is an important coastal mangrove setting and soil plays a key role in mangrove carbon storage in mangrove forests. However, the spatial variation in soil organic carbon (SOC) storage remain unclear. To address this gap, determining the SOC spatial variation in Gabonese’s estuarine is essential for better understanding the global carbon cycle. The present study compared soil organic carbon between northern and southern sites in different mangrove forest, Rhizophora racemosa and Avicennia germinans. The results showed that the mean SOC stocks at 1 m depth were 256.28 ± 127.29 MgC ha−1. Among the different regions, SOC in northern zone was significantly (p p deeper layers contained higher SOC stocks (254.62 ± 128.09 MgC ha−1) than upper layers (55.42 ± 25.37 MgC ha−1). The study highlights that low deforestation rate have led to less CO2 (705.3 Mg CO2e ha−1 - 922.62 Mg CO2e ha−1) emissions than most sediment carbon-rich mangroves in the world. These results highlight the influence of soil texture and mangrove forest types on the mangrove SOC stocks. The first national comparison of soil organic carbon stocks between mangroves and upland tropical forests indicated SOC stocks were two times more in mangroves soils (51.21 ± 45.00 MgC ha−1) than primary (20.33 ± 12.7 MgC ha−1), savanna and cropland (21.71 ± 15.10 MgC ha−1). We find that mangroves in this study emit lower dioxide-carbon equivalent emissions. This study highlights the importance of national inventories of soil organic carbon and can be used as a baseline on the role of mangroves in carbon sequestration and climate change mitigation but the variation in SOC stocks indicates the need for further national data.

关键词： Mangroves Forest Soil Organic Carbon Stocks Rizophora Racemose Avicenia germinans Gabon

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Viral hepatitis and hepatocellular carcinoma:From molecular pathways to the role of clinical surveillance and antiviral treatment

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World Journal of Gastroenterology 2022年第21期28卷 2251-2281页

作者： Leonardo stella Francesco Santopaolo Antonio Gasbarrini Maurizio Pompili Francesca Romana Ponziani Internal Medicine and Gastroenterology Hepatology UnitFondazione Policlinico Universitario Agostino Gemelli IRCCSRome 00168Italy

Hepatocellular carcinoma(HCC)is a global health *** to the high prevalence in low-income countries,hepatitis B virus(HBV)and hepatitis C virus infections remain the main risk factors for HCC occurrence,despite the increasing frequencies of non-viral *** addition,hepatitis d virus coinfection increases the oncogenic risk in patients with HBV *** molecular processes underlying HCC development are complex and various,either independent from liver disease etiology or *** reciprocal interlinkage among non-viral and viral risk factors,the damaged cellular microenvironment,the dysregulation of the immune system and the alteration of gutliver-axis are known to participate in liver cancer induction and *** mechanisms and pathways change throughout the natural history of viral hepatitis with the worsening of liver *** high risk of cancer incidence in chronic viral hepatitis infected patients compared to other liver disease etiologies makes it necessary to implement a proper surveillance,both through clinical-biochemical scores and periodic ultrasound *** review aims to outline viral and microenvironmental factors contributing to HCC occurrence in patients with chronic viral hepatitis and to point out the importance of surveillance programs recommended by international guidelines to promote early diagnosis of HCC.

关键词： Hepatitis C virus Hepatitis B virus Hepatitis d virus Hepatocellular carcinoma Cirrhosis Liver

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Experimentally unsupervised deconvolution for light-sheet microscopy with propagation-invariant beams

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Light(Science & Applications) 2022年第11期11卷 2790-2804页

作者： Philip Wijesinghe stella Corsetti darren J.X.Chow Shuzo Sakata Kylie R.dunning Kishan dholakia SUPA School of Physics and AstronomyUniversity of St AndrewsNorth HaughSt AndrewsFife KY169SSUK Robinson Research Institute Adelaide Medical SchoolThe University of AdelaideAdelaideSAAustralia Australian Research Council Centre of Excellence for Nanoscale BioPhotonics The University of AdelaideAdelaideSAAustralia Institute for Photonics and Advanced Sensing The University of AdelaideAdelaideSAAustralia Strathclyde Institute of Pharmacy and Biomedical Sciences University of StrathclydeGlasgow G4 OREUK School of Biological Sciences The University of AdelaideAdelaideSAAustralia department of Physics College of ScienceYonsei UniversitySeoul 03722South Korea

deconvolution is a challenging inverse problem,particularly in techniques that employ complex engineered pointspread functions,such as microscopy with propagation-invariant ***,we present a deep-learning method for deconvolution that,in lieu of end-to-end training with ground truths,is trained using known physics of the imaging ***,we train a generative adversarial network with images generated with the known point-spread function of the system,and combine this with unpaired experimental data that preserve perceptual *** method rapidly and robustly deconvolves and super-resolves microscopy images,demonstrating a two-fold improvement in image contrast to conventional deconvolution *** contrast to common end-to-end networks that often require 1000-10,000s paired images,our method is experimentally unsupervised and can be trained solely on a few hundred regions of *** demonstrate its performance on light-sheet microscopy with propagation-invariant Airy beams in oocytes,preimplantation embryos and excised brain tissue,as well as illustrate its utility for Bessel-beam *** method aims to democratise learned methods for deconvolution,as it does not require data acquisition outwith the conventional imaging protocol.

关键词： invariant propagation implantation

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Mapping Floods of Fenton River, an Ungauged Stream in Connecticut

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Journal of Water Resource and Protection 2022年第7期14卷 531-541页

作者： Juan M. stella department of Civil and Environmental Engineering Lamar University Beaumont TX USA

The study describes the modeling of flood events of an ungauged river by using recorded data from a neighboring watershed. The Fenton and Mount Hope Rivers are two tributaries of the Thames River in Northwest Connecticut, New England. The Fenton River was an ungauged stream until 2006, the Mount Hope River has stream discharges measurements since 1940. due to the lack of discharge measurements in the Fenton River during the XX century, there is a huge uncertainty about the characteristics of past flood events. An analysis was conducted to map the most important floods in the Fenton River around the pump wells of the University of Connecticut (UConn) with simulated peak discharges applying the drainage-area ratio methodology using recorded peak discharges from the Mount Hope River in 1955, 2005 and, 2008. Flood maps of the Fenton River were generated applying a one-dimensional (1d) HEC-RAS model for the 1955, 2005, 2008 events and a simulated 2022 flood. The methodology shows that it is possible to simulate flood maps of past events using a neighboring watershed discharges.

关键词： Floodmaps HEC-RAS Model drainage-Area Ratio Method Connecticut

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