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Secondary sclerosing cholangitis after critical COVID-19:Three case reports

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World Journal of Hepatology 2022年第8期14卷 1678-1686页

作者： Juan M Mayorquín-Aguilar Aldo Lara-Reyes Luis Alberto Revuelta-rodríguez Nayelli C Flores-García Astrid Ruiz-Margáin Marco Antonio Jiménez-Ferreira Ricardo ulises Macías-rodríguez Department of Gastroenterology Instituto Nacional de Ciencias Médicas y Nutrición Salvador ZubiránMexico City 14080Mexico Department of Pathology Instituto Nacional de Ciencias Médicas y Nutrición Salvador ZubiránMexico City 14080Mexico

BACKGROUND The global coronavirus disease 2019(COVID-19)pandemic has caused more than 5 million *** involvement is well described,including liver *** patients with critical COVID-19,a new entity called"post-COVID-19 cholangiopathy"has been *** SUMMARY Here,we present three patients with severe COVID-19 that subsequently developed persistent cholestasis and chronic liver *** three patients required intensive care unit admission,mechanical ventilation,vasopressor support,and broad spectrum antibiotics due to secondary *** transplant protocol was started for two of the three *** Severe COVID-19 infection should be considered a potential risk factor for chronic liver disease and liver transplantation.

关键词： SARS-CoV-2 Persistent cholestasis Liver chemistry Hypoxic cholangiopathy Case report

Hematological abnormalities in liver cirrhosis

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World Journal of Hepatology 2024年第9期16卷 1229-1244页

作者： Oscar Manuel Fierro-Angulo JoséAlberto González-Regueiro Ariana Pereira-García Astrid Ruiz-Margáin Fernando Solis-Huerta Ricardo ulises Macías-rodríguez Department of Gastroenterology Instituto Nacional de Ciencias Médicas y Nutrición Salvador ZubiránMexico 14080Mexico Department of Hematology Instituto Nacional de Ciencias Médicas y Nutrición Salvador ZubiránMexico 14080Mexico

Hematological abnormalities are common in cirrhosis and are associated with various pathophysiological *** have documented a prevalence of thrombocytopenia,leukopenia,and anemia in patients with compensated cirrhosis of 77.9%,23.5%,and 21.1%,*** abnormalities carry significant clinical implications,including considerations for invasive procedures,infection risk,bleeding risk,and ***,cirrhosis was believed to predispose patients to bleeding due to alterations observed in classical coagula-tion tests such as prothrombin time,partial thromboplastin time,international normalized ratio,and ***,this understanding has evol-ved,and cirrhosis patients are now also acknowledged as being at a high risk for thrombotic *** in cirrhosis patients presents a complex pheno-type,with procoagulant and anticoagulant abnormalities offsetting each *** multifactorial phenomenon is inadequately reflected by routine laboratory *** complications are more prevalent in decompensated cirrhosis and may correlate with disease *** is primarily associated with portal hypertension,endothelial dysfunction,mechanical vessel injury,dissem-inated intravascular coagulation,endotoxemia,and renal *** review comprehensively outlines hematologic index abnormalities,mechanisms of hemostasis,coagulation,and fibrinolysis abnormalities,limitations of laboratory testing,and clinical manifestations of bleeding and thrombosis in patients with liver cirrhosis.

关键词： Cirrhosis Anemia Leukopenia Thrombocytopenia Coagulopathy Bleeding Thrombosis

Nutritional therapy for hepatocellular carcinoma

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World Journal of Gastrointestinal Oncology 2021年第10期13卷 1440-1452页

作者： Astrid Ruiz-Margáin Berenice M Román-Calleja Paulina Moreno-Guillén JoséA González-Regueiro DeyaniraKúsulas-Delint Alejandro Campos-Murguía Nayelli C Flores-García Ricardo ulises Macías-rodríguez Liver Nutrition Clinic Department of GastroenterologyInstituto Nacional de Ciencias Médicas y Nutrición Salvador ZubiránMexico City 14080Mexico Liver Fibrosis and Nutrition Lab MICTLÁN-Network(Mechanisms of Liver InjuryCell Death and Translational Nutrition in Liver Diseases-Research Network)Mexico City 14080Mexico Department of Gastroenterology Instituto Nacional de Ciencias Médicas y Nutrición Salvador ZubiránMexico City 14080Mexico

Hepatocellular carcinoma(HCC)is the most frequent primary liver cancer and presents together with cirrhosis in most *** addition to commonly recognized risk factors for HCC development,such as hepatitis B virus/hepatitis C virus infection,age and alcohol/tobacco consumption,there are nutritional risk factors also related to HCC development including high intake of saturated fats derived from red meat,type of cooking(generation of heterocyclic amines)and contamination of foods with *** the contrary,protective nutritional factors include diets rich in fiber,fruits and vegetables,n-3 polyunsaturated fatty acids and *** the patient is being evaluated for staging and treatment of HCC,special attention should be paid to nutritional support,including proper nutritional assessment and therapy by a multidisciplinary *** must be considered that these patients usually develop HCC on top of long-lasting cirrhosis,and therefore they could present with severe *** complications should be properly addressed and considered for nutritional *** addition to traditional methods,functional testing,phase angle and computed tomography scan derived skeletal muscle index-L3 are among the most useful tools for nutritional *** therapy should be centered on providing enough energy and protein to manage the increased requirements of both cirrhosis and *** with branched-chain amino acids is also recommended as it improves response to treatment,nutritional status and survival,and finally physical exercise must be encouraged and adapted to individual needs.

关键词： Sarcopenia Liver Cancer Diet Branched-chain amino acids Nutrition

Performance Improvement of Artificial Neural Network Model in Short-term Forecasting of Wind Farm Power Output

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Journal of Modern Power Systems and Clean Energy 2020年第3期8卷 484-490页

作者： Sergio Velázquez Medina ulises Portero Ajenjo Department of Electronics and Automatics Engineering Universidad de Las Palmas de Gran CanariaCampus de Tafira s/n35017 Las Palmas de Gran CanariaCanary IslandsSpain School of Industrial and Civil Engineering University of Las Palmas de Gran CanariaCampus de Tafira s/n35017 Las Palmas de Gran CanariaCanary IslandsSpain

Due to the low dispatchability of wind power,the massive integration of this energy source in power systems requires short-term and very short-term wind power output forecasting models to be as efficient and stable as possible.A study is conducted in the present paper of potential improvements to the performance of artificial neural network(ANN)models in terms of efficiency and ***,current ANN models have been developed by considering exclusively the meteorological information of the wind farm reference station,in addition to selecting a fixed number of time periods prior to the *** this respect,new ANN models are proposed in this paper,which are developed by:varying the number of prior 1-h periods(periods prior to the forecasting hour)chosen for the input layer parameters;and/or incorporating in the input layer data from a second weather station in addition to the wind farm reference *** has been found that the model performance is always improved when data from a second weather station are *** mean absolute relative error(MARE)of the new models is reduced by up to 7.5%.Furthermore,the longer the forecasting horizon,the greater the degree of improvement.

关键词： Artificial neural networks(ANN) wind power forecasting model performance wind power output

Low phase angle is associated with the development of hepatic encephalopathy in patients with cirrhosis

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World Journal of Gastroenterology 2016年第45期22卷 10064-10070页

作者： Astrid Ruiz-Margáin Ricardo ulises Macías-rodríguez Javier Ampuero Francisco Javier Cubero Luis Chi-Cervera Silvia L Ríos-Torres Andrés Duarte-Rojo Ángeles Espinosa-Cuevas Manuel Romero-Gómez Aldo Torre Department of Gastroenterology Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán14080 México City México Department of Internal Medicine Ⅲ University Hospital RWTH Aachen52074 Aachen Germany Unit for the Clinical Management of Digestive Diseases Virgen del Rocio-Virgen Macarena University Hospital41009 Sevilla Spain Department of Immunology Complutense University School of Medicine28040 Madrid Spain University of Arkansas for Medical Sciences Little Rock AR 72205 United States Department of Nephrology and Mineral Merabolism Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán México City 14080 México

AIM Evaluate the association between phase angle and the development of hepatic encephalopathy in the longterm follow-up of cirrhotic *** This was a prospective cohort study. Clinical, nutritional and biochemical evaluations were performed. MannWhitney's U and χ2 tests were used as appropriate. Kaplan-Meier curves and Cox proportional Hazards analysis were used to evaluate the prediction and incidence of hepatic *** Two hundred and twenty were included; the most frequent etiology of cirrhosis was hepatitis C infection, 52% of the patients developed hepatic encephalopathy(18.6% covert and 33.3% overt); the main precipitating factors were infections and variceal bleeding. KaplanMeier curves showed a higher proportion of HE in the group with low phase angle(39%) compared to the normal phase angle group(13%)(P = 0.012). Furthermore, creatinine and phase angle remained independently associated to hepatic encephalopathy in the Cox regression multivariate analysis [hazard ratio = 1.80(1.07-3.03)]. CONCLUSION In our cohort of patients low phase angle was associated with an increased incidence of hepatic encephalopathy. Phase angle is a useful nutritional marker that evaluates cachexia and could be used as a part of the integral assessment in patients with cirrhosis.

关键词： Malnutrition Hepatic encephalopathy Phase angle Cachexia Prognosis

Simultaneous optimization of even flow and land and timber value in forest planning:a continuous approach

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Forest Ecosystems 2021年第4期8卷 645-658页

作者： Jose M.Gonzalez-Gonzalez Miguel E.Vazquez-Mendez ulises Dieguez-Aranda Departamento de Enxenaria Agroforestal Universidade de Santiago de Compostela.Escola Politecnica Superior de EnxenariaR/Benigno Ledo27002 LugoSpain Departamento de Matematica Aplicada Instituto de MatematicasUniversidade de Santiago de Compostela.Escola Politecnica Superior de EnxenariaR/Benigno Ledo27002 LugoSpain

Background:Forest management planning involves deciding which silvicultural treatment should be applied to each stand and at what time to best meet the objectives established for the *** this,many mathematical formulations have been proposed,both within the linear and non-linear programming frameworks,in the latter case generally considering integer variables in a combinatorial *** present a novel approach for planning the management of forests comprising single-species,even-aged stands,using a continuous,multi-objective formulation(considering economic and even flow)which can be solved with gradient-type ***:The continuous formulation has proved robust in forest with different structures and different number of *** results obtained show a clear advantage of the gradient-type methods over heuristics to solve the problems,both in terms of computational time(efficiency)and in the solution obtained(effectiveness).Their improvement increases drastically with the dimension of the problem(number of stands).Conclusions:It is advisable to rigorously analyze the mathematical properties of the objective functions involved in forest management planning *** continuous bi-objective model proposed in this paper works with smooth enough functions and can be efficiently solved by using gradient-type *** advantages of the new methodology are summarized as:it does not require to set management prescriptions in advance,it avoids the division of the planning horizon into periods,and it provides better solutions than the traditional combinatorial ***,the graphical display of trade-off information allows an a posteriori articulation of preferences in an intuitive way,therefore being a very interesting tool for the decision-making process in forest planning.

关键词： Even-aged forest management Forest-level optimization Continuous optimization Gradient-type algorithms

Clinical perspectives,assessment,and mechanisms of metabolicassociated fatty liver disease in patients with COVID-19

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World Journal of Gastroenterology 2021年第33期27卷 5502-5519页

作者： Alejandro Campos-Murguía Berenice M Román-Calleja JoséA González-Regueiro Ivonne Hurtado-Díaz-de-León Alberto Adrián Solís-Ortega Nayelli C Flores-García Ignacio García-Juárez Astrid Ruiz-Margáin Ricardo ulises Macías-rodríguez Department of Gastroenterology Instituto Nacional de Ciencias Médicas y Nutrición Salvador ZubiránMexico City 14080Mexico Liver Fibrosis and Nutrition Lab(LFNLab) MICTLÁN-Network(Mechanisms of Liver InjuryCell Death and Translational Nutrition in Liver Diseases-Research Network)Mexico City 14080Mexico

Metabolic diseases are highly prevalent worldwide and have been associated with adverse clinical outcomes,including mortality,in patients developing coronavirus disease(COVID-19).Because of the close relationship between metabolic diseases such as type 2 diabetes mellitus and obesity and the presence of metabolicassociated fatty liver disease(MAFLD),a high number of cases of patients affected by both MAFLD and COVID-19 would be expected,especially in highrisk *** studies have shown an increased risk of adverse clinical outcomes,viral shedding,and deep vein thrombosis,especially in patients with MAFLD-related liver *** predisposition to poor outcomes and severe acute respiratory syndrome coronavirus 2 infection in patients with MAFLD could be secondary to mechanisms common to both,including preexisting systemic chronic inflammation,endothelial dysfunction,and involvement of the renin-angiotensin *** of the increased risk of adverse outcomes,MAFLD should be screened in all patients admitted for *** computed tomography scans could be of help,assessment of liver fibrosis is also recommended,favoring noninvasive methods to limit the exposure of healthcare *** involvement in this population ranges from abnormalities in liver chemistry to hepatic steatosis in postmortem ***,preventive measures should be strongly advocated in patients already known to have MAFLD,including the use of telemedicine and vaccination in addition to general measures.

关键词： Metabolic-associated fatty liver disease COVID-19 Mortality Fibrosis Histology Epidemiology

Current trends of liver cirrhosis in Mexico: Similitudes and differences with other world regions

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World Journal of Clinical Cases 2018年第15期6卷 922-930页

作者： Nahum Méndez-Sánchez Felipe Zamarripa-Dorsey Arturo Panduro Emma Purón-González Edgar ulises Coronado-Alejandro Carlos Alejandro Cortez-Hernández Fátima Higuera de la Tijera José Luis Pérez-Hernández Eira Cerda-Reyes Heriberto rodríguez-Hernández Vania César Cruz-Ramón Oscar Lenin Ramírez-Pérez Nancy Edith Aguilar-Olivos Olga Fabiola rodríguez-Martínez Samantha Cabrera-Palma Guillermo Cabrera-álvarez Liver Research Unit Medica Sur Clinic and Foundation Department of Gastroenterology Hospital "Juárez" of México Department of Molecular Biology in Me-dicine Civil Hospital of Guadalajara "Fray Antonio Alcalde" Department of Internal Medicine "Christus Muguerza "Super Specialty" Hospital" Monterrey Department of Gas-troenterology "University Hospital "Jose Eleuterio González" Monterrey Department of Gastroenterology "General Hospital of Mexico "Dr.Eduardo Liceaga" Department of Gastroenterology "Central Military Hospital" Faculty of Medicine and Nutrition Juárez University of the State of Durango Liver Clinic Regional General Hospital IMSS 1

AIM To investigate the main current etiologies of cirrhosis in *** We performed a cross-sectional retrospective multicenter study that included eight hospitals in different areas of Mexico. These hospitals provide health care to people of diverse social classes. The inclusion criteria were a histological, clinical, biochemical, endoscopic, or imaging diagnosis of liver cirrhosis. Data were obtained during a 5-year period(January 2012-December 2017). RESULTS A total of 1210 patients were included. The mean age was 62.5 years(SD = 12.1), and the percentages of men and women were similar(52.0% vs 48.0%). The most frequent causes of liver cirrhosis were hepatitis C virus(HCV)(36.2%), alcoholic liver disease(ALD)(31.2%), and nonalcoholic steatohepatitis(23.2%), and the least frequent were hepatitis B virus(1.1%), autoimmune disorders(7.3%), and other conditions(1.0%).CONCLUSION HCV and ALD are the most frequent causes of cirrhosis in Mexico. However, we note that non-alcoholic fatty liver disease(NAFLD) as an etiology of cirrhosis increased by 100% compared with the rate noted previously. We conclude that NAFLD will soon become one of the most frequent etiologies of liver cirrhosis in Mexico.

关键词： Alcoholic liver disease Hepatitis C virus Nonalcoholic steatohepatitis Liver cirrhosis

Microstructure and mechanical behavior of similar butt-joints of ZK60 and ZK60-1.5RE magnesium alloys produced by linear friction stir welding

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Journal of Magnesium and Alloys 2021年第5期9卷 1802-1817页

作者： Erenilton Pereira da Silva Ricardo Henrique Buzolin ulises Alfaro Guillermo Requena Haroldo Calvalcanti Pinto Institute of Engineering Science and Technology(IECT)Federal University of Vales do Jequitinhonha e Mucuri(UFVJM)JanaúbaMGBrazil Department of Materials Engineering São Carlos School of Engineering(EESC)University of São Paulo(USP)São Carlos-SP CEP 13563-120Brazil Christian Doppler Laboratory for Design of High-Performance Alloys by Thermomechanical Processing Kopernikusgasse 24Graz 8010Austria Institute of Materials Science Joining and Forming at Graz University of Technology opernikusgasse 24/IGraz 8010Austria German Aerospace Center(DLR)Institute of Materials Research Linder HöheCologne 51147Germany RWTH Aachen University Metallic Structures and Materials Systems for Aerospace EngineeringD-52062 AachenGermany.

The microstructure and mechanical properties of butt-joints produced by linear friction stir welding of similar plates of as-cast ZK60 and modified ZK60 with 1.5 wt.%RE(ZK60-1.5 RE)are *** thermomechanical affected zone is investigated in both advancing and retrieving sides,and the microstructure is compared to the base metal and the stirred *** backscattered diffraction measurements provide the average microstructural features of the transformed *** mechanical properties are assessed using hardness,tensile testing,and surface residual stress measured using X-ray *** torque and heat input are obtained for the ZK60-1.5 RE compared to the *** thermomechanical affected zone is notably larger for the ZK60 compared to the ZK60-1.5 RE.A gradient microstructure is formed in thermomechanical affected zones where deformed grains are progressively more recrystallised towards the stirred *** is no visible interface between the thermomechanical affected zone and the stirred zone.A fine and partially recrystallised microstructure is formed in the stirred *** retrieving side of the ZK60-1.5 RE has a slightly more refined microstructure compared to the other investigated *** measured with increment in the maximum intensity of the(0001)increases towards to stirred *** formed microstructure is correlated with the role of twinning,recovery,static,and dynamic recrystallisation that can occur during friction stir *** and grains with large misorientation spread are more pronounced in the thermomechanical affected zone and regions towards the base *** low angle grain boundaries are observed towards the stirred *** refined recrystallised grains decorating the grain in the thermomechanical affected zone,a mosaic-like of low and high angle grain boundaries are observed in the stirred *** joints have comparable surface residual *** friction stir welding improved th

关键词： ZK60 Mischmetal FSW Recrystallization Microstructure Thermomechanical