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Pulmonary complications of hepatic diseases

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World Journal of Gastroenterology 2016年第26期22卷 6008-6015页

作者： Salim R Surani yamely mendez Humayun Anjum Joseph Varon University of North Texas Aransas Pass TX 78366 United States Dorrington Medical Associates PA and Facultad de Medicina Universidad Autonoma de Tamaulipas Houston TX 77030 United States Faculty Bay Area Medical Center Corpus Christi TX 78412 United States Clinical Medicine The University of Texas Medical Branch at Galveston Houston TX 77030 United States

Severe chronic liver disease(CLD) may result from portal hypertension, hepatocellular failure or the combination of both. Some of these patients may develop pulmonary complications independent from any pulmonary pathology that they may have. Among them the hepatopulmonary syndrome(HPS), portopulmonary hypertension(PPH) and hepatic hydrothorax(HH) are described in detail in this literature review. HPS is encountered in approximately 15% to 30% of the patients and its presence is associated with increase in mortality and also requires liver transplantation in many cases. PPH has been reported among 4%-8% of the patient with CLD who have undergone liver transplantation. The HH is another entity, which has the prevalence rate of 5% to 6% and is associated in the absence of cardiopulmonary disease. These clinical syndromes occur in similar pathophysiologic environments. Most treatment modalities work as temporizing measures. The ultimate treatment of choice is liver transplant. This clinical review provides basic concepts; pathophysiology and clinical presentation that will allow the clinician to better understand these potentially life-threatening complications. This article will review up-to-date information on the pathophysiology, clinical features and the treatment of the pulmonary complications among liver disease patients.

关键词： Portopulmonary hypertension Hepatopulmonary syndrome Cirrhosis Hepatocellular failure Hepatic hydrothorax Intrapulmonary shunting

Cystic fibrosis-related diabetes:The unmet need

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World Journal of Diabetes 2020年第6期11卷 213-217页

作者： Leonardo Pozo Fatimah Bello yamely mendez Salim Surani Internal Medicine University of Texas Rio Grande ValleyEdinburgTX 78539United States Research Department Baylor College of MedicineHoustonTexas.77030United States Medical Critical Care Services Corpus Christi Medical CenterCorpus ChristiTX 78404United States

Cystic fibrosis(CF)is a common autosomal recessive *** expectancy of patients with CF continues to improve mainly driven by the evolving therapies for CF-related organ *** prevalence of CF-related diabetes(CFRD)increases exponentially as patients’*** care guidelines for CFRD from 2010,recommend insulin as the mainstay of *** patients with CFRD may not require exogenous insulin due to the heterogeneity of this clinical *** of euglycemia by enhancing endogenous insulin production,secretion and degradation with novel pharmacological therapies like glucagonlike peptide-1 agonist is an option that remains to be fully *** such,the scope of this article will focus on our perspective of glucagon-like peptide-1 receptor agonist in the context of *** potential options such as sodiumglucose cotransporter-2 and dipeptidyl peptidase 4 inhibitors and their impact on this patient population is limited and further studies are required.

关键词： Cystic fibrosis Cystic fibrosis-related diabetes Cystic fibrosis transmembrane conductance regulator Gastric inhibitory polypeptide Glucagon-like peptide 1 Glucagon-like peptide-1 receptor agonist Dipeptidyl peptidase 4 inhibitors

Gestational diabetes mellitus and COVID-19:The epidemic during the pandemic

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World Journal of Diabetes 2023年第8期14卷 1178-1193页

作者： yamely mendez Linda A Alpuing Radilla Luis Eduardo Delgadillo Chabolla Alejandra Castillo Cruz Johanan Luna Salim Surani Department of Obstetrics and Gynecology Baylor College of MedicineHoustonTX 77030United States Department of Medicine Xochicalco UniversityMexicali 21376BCMexico Department of Medicine Mt.Olympus Medical ResearchSugarlandTX 77479United States Department of Medicine&Pharmacology Texas A&M UniversityCollege StationTX 77843United States

During the global coronavirus disease 2019(COVID-19)pandemic,people worldwide have experienced an unprecedented rise in psychological distress and *** addition to this challenging situation,the prevalence of diabetes mellitus(DM),a hidden epidemic,has been steadily increasing in recent ***-middle-income countries have faced significant barriers in providing accessible prenatal care and promoting a healthy diet for pregnant women,and the pandemic has made these challenges even more difficult to *** women are at a higher risk of developing complications such as hypertension,preeclampsia,and gestational diabetes,all of which can have adverse implications for both maternal and fetal *** occurrence of gestational diabetes has been on the rise,and it is possible that the pandemic has worsened its *** data is limited,studies conducted in Italy and Canada suggest that the pandemic has had an impact on gestational diabetes rates,especially among women in their first trimester of *** significant disruptions to daily routines caused by the pandemic,such as limited exercise options,indicate a possible link between COVID-19 and an increased likelihood of experiencing higher levels of weight gain during ***,individuals in the United States with singleton pregnancies are at a significantly higher risk of excessive gestational weight gain,making this association particularly important to *** comprehensive data is currently lacking,it is important for clinical researchers to explore the possibility of establishing correlations between the stress experienced during the pandemic,its consequences such as gestational gain weight,and the increasing incidence of gestational *** knowledge would contribute to better preventive measures and support for pregnant individuals during challenging times.

关键词： Pregnancy Gestational diabetes Stress Social determinants Pandemic COVID-19 Diabetes type 1 Diabetes type 2 Insulin Diabetes mellitus treatment

Novel pharmacological therapy in type 2 diabetes mellitus with established cardiovascular disease: Current evidence

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World Journal of Diabetes 2019年第5期10卷 291-303页

作者： Leonardo Pozo Fatimah Bello Andres Suarez Francisco E Ochoa-Martinez yamely mendez Chelsea H Chang Salim Surani University of Texas Rio Grande Valley-Doctors Hospital at Renaissance Internal Medicine Residency Program Faculty of Medicine Universidad Autonoma de Nuevo LeonUniversity Hospital "Dr. José Eleuterio González" Faculty of Medicine "Dr. Alberto Romo Caballero" Universidad Autonoma de Tamaulipas Medical Critical Care Services Christus Spohn Hospitals-Corpus Christi

Cardiovascular diseases(CVDs) remain the leading cause of death in the world and in most developed countries. Patients with type 2 diabetes mellitus(T2DM)suffer from both microvascular and macrovascular diseases and therefore have higher rates of morbidity and mortality compared to those without T2DM. If current trends continue, the Center for Disease Control and Prevention estimates that 1 in 3 Americans will have T2DM by year 2050. As a consequence of the controversy surrounding rosiglitazone and the increasing prevalence of diabetes and CVDs, in 2008 the Food and Drug Administration(FDA) established new expectations for the evaluation of new antidiabetic agents, advising for pre and,in some cases, post-marketing data on major cardiovascular events. As a direct consequence, there has been a paradigm shift in new antidiabetic agents that has given birth to the recently published American Diabetes Association/European Association for the Study of Diabetes consensus statement recommending sodium-glucose cotransporter-2 inhibitors(SGLT2i) and glucagon like peptide-1 receptor agonists(GLP-1RA) in patients with T2DM and established CVD. As a result of over a decade of randomized placebo controlled cardiovascular outcome trials, the aforementioned drugs have received FDA approval for risk reduction of cardiovascular(CV) events in patients with T2DM and established CV ***2i have been shown to have a stronger benefit in patients with congestiveheart failure and diabetic kidney disease when compared to their GLP-1RA counterparts. These benefits are not withstanding additional considerations such as cost and the multiple FDA Black Box warnings. This topic is currently an emerging research area and this mini-review paper examines the role of these two novel classes of drugs in patients with T2DM with both confirmed, and at risk for, CVD.

关键词： Type 2 diabetes mellitus Glucagon-like-peptide 1 agonists Sodium-glucose cotransporter-2 inhibitor Cardiovascular disease Major adverse cardiovascular event