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地中海明珠

建筑实践 2014年第6期 8-13页

作者：李莹 antonio López Espada

项目名称:The Mediterranean Peart建筑设计:Spainville主要建筑师:Carios Gilardl项目地点:Morro de Toix,Allcante,Spain建筑面积:421 m2花园面积:260m2完工时间:2014在西班牙美丽的海滨城市阿利坎特,建筑师卡洛斯·吉拉迪（carlos Gilardi）建造了这个令人印象深刻、名为地中海明珠的私人别墅。项目笔直、规矩的极简直线传达出强烈的现代风格。建筑师希望借助线性的合力,在壮丽的海景与住宅的良好功能性之间寻求一种平衡。

关键词：落地窗拉迪主卧地中海建筑师美术家露台园林建筑卡洛斯别墅玻璃窗卧室泳池

Liver biopsy for visceral leishmaniasis diagnosis in pregnancy: report of 2 cases

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World Journal of Clinical Infectious Diseases 2013年第2期3卷 20-24页

作者： Talles Bazeia Lima Clarissa Ribeiro Villar Maria Aparecida Marchesan Rodrigues Júlio Pinheiro Baima Fábio da Silva Yamashiro Letícia campos Franzoni carlos antonio Caramori Giovanni Faria Silva Fernando Gomes Romeiro Lígia Yukie Sassaki department of Internal Medicine Division of GastroenterologyBotucatu School of MedicineSao Paulo18618-970Brazil department of Pathology Botucatu School of MedicineSao Paulo18618-970Brazil

Visceral leishmaniasis(VL) or kala-azar is a zoonosis caused by intracellular protozoa of the Leishmania genus and is transmitted to humans by the bite of phlebotomine sandflies. It particularly affects cells in the phagocytic mononuclear system, accompanied by disturbances of cellular and humoral immunity. VL is potentially fatal and is characterized by fever, hepatosplenomegaly, diarrhea, epistaxis, jaundice, anemia, leucopenia, thrombocytopenia, hypoalbuminemia and hyperglobulinemia. Diagnostic suspicion is based on epidemiological, clinical and laboratory data and isconfirmed by detecting the parasite in infected tissue. Splenic aspiration is the most sensitive method, followed by bone marrow aspiration(BMA) by sternal puncture, liver biopsy and lymph node aspiration; but, due to safety concerns, BMA is the most recommended method. VL is included as a target disease by players in drug research and development. Severe liver dysfunction associated with VL is uncommon. We report two VL cases in pregnant women from Bauru, Sao Paulo state, Brazil, considered an endemic area. The first of them developed hepatic failure due to fulminant hepatitis. In both cases, BMA was unable to find the protozoan; thus, liver biopsy was the only means of making the diagnosis.

关键词： Visceral Leishmaniasis Infection in pregnancy Liver biopsy Bone marrow aspirate Differential diagnosis

Gallstone ileus,clinical presentation,diagnostic and treatment approach

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World Journal of Gastrointestinal Surgery 2016年第1期8卷 65-76页

作者： carlos m nuno-guzmán maría eugenia marín-contreras mauricio figueroa-sánchez jorge l corona department of general surgery hospital civil de guadalajara"fray antonio alcalde"Guadalajara CP 44280JaliscoMéxico department of general surgery unidad médica de alta especialidadhospital de especialidades del centro médico nacional de occidenteinstituto mexicano del seguro socialGuadalajara CP 44340JaliscoMéxico department of gastrointestinal endoscopy unidad médica de alta especialidadhospital de especialidades del centro médico nacional de occidenteinstituto mexicano del seguro socialGuadalajara CP 44340JaliscoMéxico department of radiology hospital civil de guadalajara"fray antonio alcalde"Guadalajara CP 44280JaliscoMéxico

Gallstone ileus is a mechanical intestinal obstruction due to gallstone impaction within the gastrointestinal tract. Less than 1% of cases of intestinal obstruction are derived from this etiology. The symptoms and signs of gallstone ileus are mostly nonspecific. This entity has been observed with a higher frequency among the elderly, the majority of which have concomitant medical illness. Cardiovascular, pulmonary, and metabolic diseases should be considered as they may affect the prognosis. Surgical relief of gastrointestinal obstruction remains the mainstay of operative treatment. The current surgical procedures are:(1) simple enterolithotomy;(2) enterolithotomy, cholecystectomy and fistula closure(one-stage procedure); and(3) enterolithotomy with cholecystectomy performed later(two-stage procedure). Bowel resection is necessary in certain cases after enterolithotomy is performed. Large prospective laparoscopic and endoscopic trials are expected.

关键词： Intestinal obstruction Bouveret's syndrome Laparoscopic surgery Endoscopic treatment Gallstoneileus

Beta-blocker therapy in elderly patients with renal dysfunction and heart failure

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Journal of Geriatric Cardiology 2021年第1期18卷 20-29页

作者： Juan Martínez-Milla Marcelino Cortés García Julia Anna Palfy Mikel Taibo Urquía Marta López Castillo Ana devesa Arbiol Ana Lucía Rivero Monteagudo María Luisa Martín Mariscal Inés Jiménez-Varas Sem Briongos Figuero Juan antonio Franco-Pelaéz JoséTuñón department of Cardiology Hospital Universitario Fundación Jiménez Díaz-Quirónsalud Centro Nacional de Investigaciones Cardiovasculares MadridSpain department of Cardiology Hospital Central de Asturias department of Cardiology Hospital Universitario Ruber-Quirónsalud department of Cardiology Hospital Universitario Infanta Leonor department of Endocrinology Hospital Clínico San Carlos Universidad Autónoma de Madrid CIBERCV MadridSpain

OBJECTIVE To assess the role of beta-blockers(BB)in patients with chronic kidney disease(CKD)aged≥75 *** AND RESULTS From January 2008 to July 2014,we included 390 consecutive patients≥75 years of age with ejection fraction≤35%and glomerular filtration rate(GFR)≤60 m L/min per 1.73 m^*** analyzed the relationship between treatment with BB and mortality or cardiovascular *** mean age of our population was 82.6±4.1 *** ejection fraction was 27.9%±6.5%.GFR was 60-45 m L/min per 1.73 m^2 in 50.3%of patients,45-30 m L/min per 1.73 m^2 in 37.4%,anddeath or hospitalization for heart failure).BB use was significantly associated with a reduced risk of death(HR=0.51,95%CI:0.35-0.74;Pdeath across the different stages of CKD:stage IIIa(GFR=30-45 m L/min per 1.73 m^2;HR=0.47,95%CI:0.26-0.86,Pderly patients with HFr EF and renal impairment was associated with a better *** of BB should be encouraged when possible.

关键词： CKD GFR Beta-blocker therapy in elderly patients with renal dysfunction and heart failure

dendritic cell deficiencies persist seven months after SARS-CoV-2 infection

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Cellular & Molecular Immunology 2021年第9期18卷 2128-2139页

作者： Alberto Pérez-Gómez Joana Vitallé Carmen Gasca-Capote Alicia Gutierrez-Valencia María Trujillo-Rodriguez Ana Serna-Gallego Esperanza Muñoz-Muela María de los Reyes Jiménez-Leon Mohamed Rafii-El-Idrissi Benhnia Inmaculada Rivas-Jeremias Cesar Sotomayor Cristina Roca-Oporto Nuria Espinosa Carmen Infante-Domínguez Juan carlos Crespo-Rivas Alberto Fernández-Villar Alexandre Pérez-González Luis Fernando López-Cortés Eva Poveda Ezequiel Ruiz-Mateos JoséMiguel Cisneros Sonsoles Salto-Alejandre Judith Berastegui-Cabrera Pedro Camacho-Martínez Carmen Infante-Domínguez Marta Carretero-Ledesma Juan carlos Crespo-Rivas Eduardo Márquez JoséManuel Lomas Claudio Bueno Rosario Amaya Joséantonio Lepe Jerónimo Pachón Elisa Cordero Javier Sánchez-Céspedes Manuela Aguilar-Guisado Almudena Aguilera Clara Aguilera Teresa Aldabo-Pallas Verónica Alfaro-Lara Cristina Amodeo Javier Ampuero María Dolores Avilés Maribel Asensio Bosco Barón-Franco Lydia Barrera-Pulido Rafael Bellido-Alba Máximo Bernabeu-Wittel Candela Caballero-Eraso Macarena Cabrera Enrique Calderón Jesús Carbajal-Guerrero Manuela Cid-Cumplido Yael Corcia-Palomo Juan delgado antonio Domínguez-Petit Alejandro deniz Reginal Dusseck-Brutus Ana Escoresca-Ortega Fátima Espinosa Nuria Espinosa Michelle Espinoza Carmen Ferrándiz-Millón Marta Ferrer Teresa Ferrer Ignacio Gallego-Texeira Rosa Gámez-Mancera Emilio García Horacio García-delgado Manuel García-Gutiérrez María Luisa Gascón-Castillo Aurora González-Estrada demetrio González Carmen Gómez-González Rocío González-León Carmen Grande-Cabrerizo Sonia Gutiérrez carlos Hernández-Quiles Inmaculada Concepción Herrera-Melero Marta Herrero-Romero Luis Jara carlos Jiménez-Juan Silvia Jiménez-Jorge Mercedes Jiménez-Sánchez Julia Lanseros-Tenllado Carmina López Isabel López Álvaro López-Barrios Luis F.López-Cortés Rafael Luque-Márquez Daniel Macías-García Guillermo Martín-Gutiérrez Luis Martín-Villén JoséMolina Aurora Morillo María Dolores Navarro-Amuedo Dolores Nieto-Martín Francisco Ortega María Paniagua-García Amelia Peña-Rodríguez E Clinical Unit of Infectious Diseases Microbiology and Preventive MedicineInstitute of Biomedicine of Seville(IBiS)Virgen del Rocío University HospitalCSICUniversity of SevilleSevilleSpain department of Medical Biochemistry Molecular Biologyand ImmunologySchool of MedicineUniversity of SevilleSevilleSpain Pneumology Service Galicia Sur Health Research Instituto(IIS Galicia Sur)SERGAS-UVigoVigoSpain Infectious Diseases Unit Department of Internal MedicineComplexo HospitalarioUniversitario de VigoIIS Galicia SurSERGAS-UVigoVigoSpain Group of Virology and Pathogenesis Galicia Sur Health Research Institute(IIS Galicia Sur)-Complexo Hospitalario Universitario de VigoSERGAS-UVigoVigoSpain Unit of Infectious Diseases Microbiologyand Preventive MedicineVirgen del Rocío University HospitalSevilleSpain Institute of Biomedicine of Seville(IBiS) Virgen del Rocío University Hospital/CSIC/University of SevilleSevilleSpain Medico-Surgical Unit of Respiratory Diseases Virgen del Rocío University HospitalSevilleSpain Unit of Emergencies Virgen del Rocío University HospitalSevilleSpain Intensive Care Unit Virgen del Rocío University HospitalSevilleSpain department of Medicine University of SevilleSevilleSpain Cardiology and Cardiovascular Surgery Unit Virgen del Rocío University HospitalSevilleSpain Rheumatology Unit Virgen del Rocío University HospitalSevilleSpain Internal Medicine Unit Virgen del Rocío University HospitalSevilleSpain Digestive and Hepatobiliary Unit Virgen del Rocío University HospitalSevilleSpain Neurology and Clinical Neurophysiology Unit Virgen del Rocío University HospitalSevilleSpain Endocrinology and Nutrition Unit Virgen del Rocío University HospitalSevilleSpain Urology and Nephrology Unit Virgen del Rocío University HospitalSevilleSpain Unit of Clinical Investigation and Clinical Trials Virgen del Rocío University HospitalSevilleSpain

Severe Acute Respiratory Syndrome Coronavirus(SARS-CoV)-2 infection induces an exacerbated inflammation driven by innate immunity *** cells(DCs)play a key role in the defense against viral infections,for instance plasmacytoid DCs(pDCs),have the capacity to produce vast amounts of interferon-alpha(IFN-α).In COVID-19 there is a deficit in DC numbers and IFN-αproduction,which has been associated with disease *** this work,we described that in addition to the DC deficiency,several DC activation and homing markers were altered in acute COVID-19 patients,which were associated with multiple inflammatory ***,previously hospitalized and nonhospitalized patients remained with decreased numbers of CD1c+myeloid DCs and pDCs seven months after SARS-CoV-2 ***,the expression of DC markers such as CD86 and CD4 were only restored in previously nonhospitalized patients,while no restoration of integrinβ7 and indoleamine 2,3-dyoxigenase(IDO)levels were *** findings contribute to a better understanding of the immunological sequelae of COVID-19.

关键词： SARS-CoV-2 COVID-19 dendritic cell Long-COVID

The Impact of Chronic Pelvic Pain in Women

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International Journal of Clinical Medicine 2013年第10期4卷 421-427页

作者： Adriana Peterson Mariano Salata Romao Ricardo Gorayeb Gustavo Salata Romao Omero Benedicto Poli-Neto antonio Alberto Nogueira department of Gynecology and Obstetrics School of Medicine of Ribeirao PretoUniversity of Sao PauloRibeirao PretoSPBra-zil department of Neurosciences and Behavioral Sciences School of Medicine of Ribeirao PretoUniversity of Sao PauloRibeirao PretoSPBrazil Federal University of Sao carlos SPBrazil department the Surgery and Anatomy University HospitalFaculty of Medicine of Ribeirao PretoUniversity of São PauloRibeirao PretoSPBrazil department of the Surgery and Anatomy Uni-versity HospitalFaculty of Medicine of Ribeirao PretoUniversity of Sao PauloRibeirao PretoSPBrazil.

Chronic pelvic pain (CPP) is a prevalent condition with a significant impact on the personal, social, professional and marital life of women. It is a complex condition that may have no specific causal diagnosis or may be associated with multiple diagnoses, frequently involving treatment failure. The definition of health care strategies fundamentally depends on the way women live with this condition. Thus, the objective of the present study is to learn how women with CPP experience their diagnosis and the meaning they attribute to it. A qualitative study was conducted by interviewing a focus group of 11 women. The content of the interviews was recorded and fully transcribed, and the speeches were interpreted by Bardin’s content analysis. The topics most frequently dealt with in the interview were diagnosis, beginning of pain, worsening and improving factors, marital and interpersonal relationships, interference with daily activities, association with emotional aspects, and perspectives for the future. It could be perceived how much these women need to be better heard and how much the association between psychic and physical questions must be visualized by the professionals who provide care for them. The approach used by professionals from different areas, when properly structured, can minimize the problem of the division of a sick person into separate parts. Psychological care is very important, especially in relation to the discovery of more effective strategies for living with pain.

关键词： Lived Experience Chronic Pelvic Pain Qualitative Method Women’s Health

Multiple myeloma mesenchymal stromal cells: Contribution to myeloma bone disease and therapeutics

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World Journal of Stem Cells 2014年第3期6卷 322-343页

作者： antonio Garcia-Gomez Fermin Sanchez-Guijo M Consuelo del Caizo Jesus F San Miguel Mercedes Garayoa Cancer Research Center IBMCC(University of Salamanca-CSIC) Institute of Biomedical Research of Salamanca University Hospital Network of Centers for Regenerative Medicine and Cellular Therapy fromCastilla y León Spanish Cooperative Research Network in Cellular Therapy Center for Applied Biomedical Research Clinic University of Navarra

Multiple myeloma is a hematological malignancy inwhich clonal plasma cells proliferate and accumulate within the bone marrow. The presence of osteolytic le-sions due to increased osteoclast(OC) activity and sup-pressed osteoblast(OB) function is characteristic of the disease. The bone marrow mesenchymal stromal cells(MSCs) play a critical role in multiple myeloma patho-physiology, greatly promoting the growth, survival, drug resistance and migration of myeloma cells. Here, we specifically discuss on the relative contribution of MSCs to the pathophysiology of osteolytic lesions in light of the current knowledge of the biology of my-eloma bone disease(MBD), together with the reported genomic, functional and gene expression differences between MSCs derived from myeloma patients(pMSCs) and their healthy counterparts(dMSCs). Being MSCs the progenitors of OBs, pMSCs primarily contribute to the pathogenesis of MBD because of their reduced osteogenic potential consequence of multiple OB inhibi-tory factors and direct interactions with myeloma cells in the bone marrow. Importantly, pMSCs also readily contribute to MBD by promoting OC formation and ac-tivity at various levels(i.e., increasing RANKL to OPG expression, augmenting secretion of activin A, uncou-pling ephrinB2-EphB4 signaling, and through augment-ed production of Wnt5a), thus further contributing to OB/OC uncoupling in osteolytic lesions. In this review, we also look over main signaling pathways involved in the osteogenic differentiation of MSCs and/or OB activity, highlighting amenable therapeutic targets; in parallel, the reported activity of bone-anabolic agents(at preclinical or clinical stage) targeting those signaling pathways is commented.

关键词： Mesenchymal stromal cells Multiple myelo-ma Osteolytic lesions Myeloma bone disease Bone-directed therapy Bone-anabolic drugs

Gut epithelial barrier dysfunction in humanimmunodeficiency virus-hepatitis C virus coinfectedpatients:Influence on innate and acquired immunity

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World Journal of Gastroenterology 2016年第4期22卷 1433-1448页

作者： Mercedes Márquez Clotilde Fernández Gutiérrez delÁlamo Joséantonio Girón-González department of Internal Medicine Infectious Disease UnitPuerta del Mar University HospitalUniversity of Cadiz11009 CádizSpain Servicio de Medicina Interna Hospital Universitario Puerta del Mar11009 CádizSpain

Even in cases where viral replication has been controlled by antiretroviral therapy for long periods of time, human immunodeficiency virus(HIV)-infected patients have several non-acquired immunodeficiency syndrome(AIDS) related co-morbidities, including liver disease, cardiovascular disease and neurocognitive decline, which have a clear impact on survival. It has been considered that persistent innate and acquired immune activation contributes to the pathogenesis of these non-AIDS related diseases. Immune activation has been related with several conditions, remarkably with the bacterial translocation related with the intestinal barrier damage by the HIV or by hepatitis C virus(HCV)-related liver cirrhosis. Consequently, increased morbidity and mortality must be expected in HIV-HCV coinfected patients. Disrupted gut barrier lead to an increased passage of microbial products and to an activation of the mucosal immune system and secretion of inflammatory mediators, which in turn might increase barrier dysfunction. In the present review, the intestinal barrier structure, measures of intestinal barrier dysfunction and the modifications of them in HIV monoinfection and in HIV-HCV coinfection will be considered. Both pathogenesis and the consequences for the progression of liver disease secondary to gut microbial fragment leakage and immune activation will be assessed.

关键词： human immunodeficiency virus infection hepatitis C virus infection Innate immunity Acquiredimmunity Gut barrier

Hepatitis C: Problems to extinction and residual hepatic and extrahepatic lesions after sustained virological response

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World Journal of Hepatology 2022年第1期14卷 62-79页

作者： Sara Cuesta-Sancho Mercedes Márquez-Coello Francisco Illanes-Álvarez denisse Márquez-Ruiz Ana Arizcorreta Fátima Galán-Sánchez Natalia Montiel Manuel Rodriguez-Iglesias José-antonio Girón-González Medicina Interna Hospital Universitario Puerta del MarFacultad de MedicinaUniversidad de CádizInstituto para la Investigación e Innovación en Ciencias Biomédicas de Cádiz(INiBICA)Cádiz 11009Spain Microbiología Hospital Universitario Puerta del MarFacultad de MedicinaUniversidad de CádizInstituto para la Investigación e Innovación en Ciencias Biomédicas de Cádiz(INiBICA)Cádiz 11009Spain

Loss of follow-up or reinfections hinder the expectations of hepatitis C eradicationdespite the existence of highly effective treatments. Moreover, the elimination ofthe infection does not imply the reversion of those chronic alterations derivedfrom the previous infection by hepatitis C virus (HCV). This review analyzes therisk factors associated with loss to follow-up in diagnosis or treatment, and thepossibility of reinfection. Likewise, it assesses the residual alterations induced bychronic HCV infection considering the liver alterations (inflammation, fibrosis,risk of decompensation, hepatocellular carcinoma, liver transplantation) and, onthe other hand, the comorbidities and extrahepatic manifestations (cryoglobulinemia,non-Hodgkin lymphoma, peripheral insulin resistance, and lipid, boneand cognitive alterations). Peculiarities present in subjects coinfected with humanimmunodeficiency virus are analyzed in each section.

关键词： Hepatitis C virus Sustained virological response Direct antiviral agents Human immunodeficiency virus Cirrhosis decompensation Hepatocarcinoma Extrahepatic complications