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Role of double-balloon enteroscopy in malignant small bowel tumors

World Journal of Gastrointestinal Endoscopy 2015年第6期7卷 652-658页

作者： Enrique Pérez-Cuadrado Robles Pilar Esteban Delgado Paloma Bebia Conesa blanca Martínez Andrés Milivoj Franulic Guggiana Eduardo Alcaraz Mateos Mariana Fernández Caballero José Luis Rodrigo Agudo Silvia Chacón Martínez Rafael Latorre Federico Soria Juan Manuel Herrerías Gutiérrez Enrique Pérez-Cuadrado Martínez Department of Gastroenterology Morales Meseguer Hospital Department of Radiology Morales Meseguer Hospital Department of Pathology Morales Meseguer Hospital Department of Hematology and Oncology Morales Meseguer Hospital Department of Anatomy University of Murcia Centre Jesus Usón Hospital Universitario Virgen Macarena

AIM: To assess the double-balloon enteroscopy(DBE) role in malignant small bowel tumors(MSBT).METHODS: This is a retrospective descriptive study performed in a single center. All consecutive patients who underwent a DBE with final diagnosis of a malignant neoplasm from 2004 to 2014 in our referral center were included. Patient demographic and clinical pathological characteristics were recorded and reviewed. MSBT diagnosis was achieved either by DBE directed biopsy with multiple tissue sampling, endoscopic findings or histological analysis of surgical specimen. We have analyzed double-balloon enteroscopy impact in outcome and clinical course of these patients. RESULTS: Of 627 patients, 28(4.5%)(mean age = 60 ± 17.3 years) underwent 30 procedures(25 anterograde, 5 retrograde) and were diagnosed of a malignant tumor. Patients presented with obscure gastrointestinal bleeding(n = 19, 67.9%), occlusion syndrome(n = 7, 25%) and diarrhea(n = 1, 3.6%). They were diagnosed by DBE biopsy(n = 18, 64.3%), histological analysis of surgical specimen(n = 7, 25%) and unequivocal endoscopic findings(n = 2, 7.1%). Gastrointestinal stromal tumor(n = 8, 28.6%), adenocarcinoma(n = 7, 25%), lymphoma(n = 4, 14.3%), neuroendocrine tumor(n = 4, 14.3%), metastatic(n = 3, 10.7%) and Kaposi sarcoma(n = 1, 3.6%) were identified. DBE modified outcome in 7 cases(25%), delaying or avoiding emergency surgery(n = 3), modifying surgery approach(n = 2) and indicating emergency SB partial resection instead of elective approach(n = 2).CONCLUSION: DBE may be critical in the management of MSBT providing additional information that may be decisive in the clinical course of these patients.

关键词： Double balloon enteroscopy Malignantsmall bowel tumors Obscure gastrointestinal bleeding Gastrointestinal stromal tumor Occlusion syndrome

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左旋肉碱通过上调过氧化物酶体增殖物激活受体γ水平减轻高血压大鼠肾脏纤维化

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中华高血压杂志 2014年第5期22卷 498-498页

作者： Zambrano S blanca AJ Ruiz-Armenta MV Miguel-Carrasco JL Arévalo M Mate A Vázquez CM 罗冬梅叶鹏

肾脏纤维化是高血压发展的不良后果之一。左旋肉碱在脂肪酸β氧化中起重要作用。研究者之前已经证实，左旋肉碱有降低血压、抗氧化、抗炎作用。该研究分析左旋肉碱对肾脏组织纤维化的影响，

关键词：过氧化物酶体增殖物激活受体γ 肾脏纤维化高血压大鼠左旋肉碱减轻脂肪酸β氧化组织纤维化降低血压

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Efficacy of a Strategy for Implementing Guidelines for the Control of Cardiovascular Risk in Primary Healthcare

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World Journal of Cardiovascular Diseases 2020年第3期10卷 117-130页

作者： Maria Jesús Fernández-Luque Luis María Sánchez-Gómez Vicente Pastor y Aldeguer Carmen Suárez-Fernández Belén Sierra-García Soledad Mayayo-Vicente Marta Ruiz-López ángela Gallego-Arenas Rosa Sánchez Alcalde Pilar Loeches-Belinchón Javier López-González Francisco Rodríguez-Salvanés blanca Novella-Arribas Dirección General de Investigación Docencia y Documentación Consejería de Sanidad Comunidad de Madrid Madrid Spain Instituto de Investigación Sanitaria del Hospital Universitario de La Princesa (IP) Madrid Spain Universidad Autónoma de Madrid Facultad de Medicina Madrid Spain Hospital Universitario de la Princesa SERMAS Consejería de Sanidad Comunidad de Madrid Madrid Spain Gerencia Asistencial de Atención Primaria D.G. de Coordinación de Asistencia Sanitaria SERMAS Consejería de Sanidad Comunidad de Madrid Madrid Spain Unidad de Evaluación de Tecnologías Sanitarias de Madrid Procesos Integrados de Salud Consejería de Sanidad Madrid Spain

Background: A number of strategies exist for the implementation of clinical practice guides (CPGs). Aim: To assess the efficacy of implementing a cardiovascular risk CPG based on an educational method involving opinion leaders, and the habitual method of dissemination among primary healthcare teams. Design and Setting: Controlled, blinded, community intervention trial randomised by clusters. Methods: 21 primary healthcare centres were randomly assigned to either the intervention arm (n = 11) or the control arm (n = 10). The study subjects were patients aged ≥45 years assigned to the centres. The overall impact of the intervention was measured as the difference between the increase in the proportion of patients whose medical records showed the recording of all the variables necessary to calculate cardiovascular risk in both arms. Analyses were performed with Generalized Lineal Model on an intention-to-treat basis. Results: 917 subjects were included at the beginning of the trial (437 in the intervention arm and 480 in the control arm). 826 subjects were included in the final evaluation (436 in the intervention group and 390 in the control arm). At the end of the trial, the recording of the variables necessary for the calculation of the cardiovascular risk in the intervention group had increased more than in the control group (difference between increases 7.49% (95% CI 4.62 - 10.35)) after adjusting for confounding variables. Conclusions: Compared to the habitual method of dissemination, the implementation of this CPG using an educational method involving opinion leaders, improved the recording of the variables needed to calculate patients’ cardiovascular risk.

关键词： Randomized Controlled Trial Cluster Analysis Clinical Practice Guidelines Primary Healthcare Risk Factors Cardiovascular Diseases

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Breast Reconstruction: Does It Worth to Start If the Patient Is Not Sure to Take All the Process Along?

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Journal of Biosciences and Medicines 2022年第8期10卷 201-209页

作者： Jesús Ricardo García-Corral José Martínez-Lopez Rodrigo Davila-Diaz blanca Arambula-Sanchez Marco Cuervo-Vergara Fernando Barbosa-Villarreal Daniel De Luna Ana Priscila Campollo Lopez Fernando Isaac Recio Espana Alfredo Chama Naranjo Jaime García Alejandro Costa David Flores-Soto Selina Marioni-Manriquez Patricia Lopez-Medellin Erika Barlandas-Quintana Edgar Guillen-Martinez Steve Rodriguez-Alanis Cuahutemoc Marquez Departamento de Cirugía Plástica y Reconstructiva Hospital Central Sur de Alta Especialidad PEMEX Mexico City Mexico

Introduction: Breast cancer is the most common cancer in women worldwide, representing a major public health problem. There is still little information comparing the satisfaction of the patients who finished their process against the ones who start it but did not finish it. The aim of our retrospective study was to analyze the results in terms of satisfaction after one year of undergoing to complete breast reconstruction (CBR) vs incomplete breast reconstruction (IBR). Materials and Methods: Retrospective study of patients that underwent breast reconstruction (BR) surgery after mastectomy for breast cancer treatment. Performed at Hospital Central Sur de Alta Especialidad PEMEX in Mexico City, including patients from January 1, 2015 to January 01, 2020. Demographic baseline variables were included. BREAST-Q satisfaction questionnaires one year after the last reconstructive procedure were analyzed. Results: A total of 44 patients fulfilled the inclusion criteria. Of these 44 patients, 11 were included in the IBR group, and 33 patients in the CBR group. There were no statistically significant differences between the two groups in terms of age (IBR 56.09 vs CBR 53.06 years, p = 0.321);BMI (IBR 27.94 vs CBR 26.40, p = 0.253), time from mastectomy to first reconstructive procedure (IBR 22.8 vs CBR 31 months, p = 0.957), history of chemotherapy (IBR 27.3% vs CBR 33.3%, p = 0.709) and radiotherapy (IBR 54.5% vs CBR 42.4%, p = 0.484), additionally type of reconstruction, affected side or complication rate were not significantly different. Regarding postoperative satisfaction, only the second module of satisfaction with breasts displayed statistically significant differences, with a higher score in the CBR group (46.27 vs 52.27, p = 0.019). Other items explored didn’t show significant differences. Discussion: The data reported in this study suggest that regardless of whether the last stage of a BR is reached, the results in these settings can be very similar in terms of psych

关键词： BREAST-Q Breast Reconstruction Satisfaction Index Quality of Life Breast Cancer Patient’s Decision Making

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Comprehensive Left Ventricular Mechanics Analysis by Speckle Tracking Echocardiography in COVID-19

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World Journal of Cardiovascular Diseases 2021年第2期11卷 113-125页

作者： Francisco J. González-Ruiz Emmanuel A. Lazcano-Díaz Zuilma Y. Vásquez-Ortiz Fernanda Bernal-Ceballos Rodrigo Gopar-Nieto Consuelo Orihuela-Sandoval José P. Hernández-Reyes Edgar García-Cruz Eduardo Bucio-Reta Ángel Ramos-Enríquez Luis A. Cota-Apodaca Luis Efren-Santos blanca Estela Broca-García Daniel Manzur-Sandoval Efrén Melano-Carranza Fernandez de la Reguera Guillermo Gustavo Rojas-Velasco Francisco Baranda-Tovar Department of Cardiovascular Critical Care National Institute of Cardiology “Dr. Ignacio Chávez” México City México Department of Echocardiography National Institute of Medical Science and Nutrition “Dr. Salvador Zubirán” México City México PhD Program National University of Mexico (UNAM) México City México Cardiovascular Diseases Department National Institute of Cardiology “Dr. Ignacio Chávez” México City México

Background: Cardiac involvement and the consequences of inflammation induced by SARS-CoV2 infection could have catastrophic long-term consequences. Left ventricular mechanics could identify a specific pattern of myocardial fiber damage in patients infected with COVID-19. To our knowledge there are no publications referring to the global description of ventricular mechanics in patients with COVID-19. Objective: To describe left ventricular mechanics in hospitalized patients with COVID-19. Methods: In this cross-sectional study, we included 40 hospitalized patients with confirmed diagnostic of COVID-19, from April 11, 2020, to September 6, 2020. Demographic and laboratory data, clinical and echocardiographic characteristics were collected, as well as events during hospitalization. Left ventricular deformation was analyzed and reported. Results: Subclinical dysfunction was observed in 82.5% (left ventricular longitudinal strain [LVGLS] -17.05% and global circumferential strain [GCS] -18.6%) of the patients, likewise, the mean twist and apical rotation were preserved, and even increased as part of the compensating mechanism to maintain the ejection fraction. Conclusion: In patients hospitalized with COVID-19, despite having a normal left ventricular ejection fraction, subclinical myocardial damage was found, manifested by a decrease in Global Longitudinal Strain (GLS) and Global Circumferential Strain (GCS). This behavior is similar to that of cardiomyopathies in the early stage of the disease, and given the pathophysiological mechanisms involved in the disease, its long-term consequences should be monitored and evaluated.

关键词： COVID-19 Speckle Tracking Echocardiography Myocarditis Cardiomyopa-thy Cardiac Mechanics Strain Myocardial Damage Deformation Imaging Myocardial Strain

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当代社会住宅的可持续性与交往空间

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时代建筑 2011年第4期54卷 62-69页

作者：布兰卡.列奥亚历杭德罗.阿奎雷.德.卡塞尔田丹妮布兰卡.列奥建筑事务所马德里理工大学高等建筑学院阿科米星建筑设计事务所

人类的私密空间何以如此重要?因为它是追求个体自由自主的表现,或是由于居民将其居住体验视为对抗21世纪未知与危机的有效手段?个人的住家是否就是"地图上的绿洲"?家是不是人们最隐秘的堡垒,他们从这里获得未曾拥有的所有力量?带着对上... 详细信息

人类的私密空间何以如此重要?因为它是追求个体自由自主的表现,或是由于居民将其居住体验视为对抗21世纪未知与危机的有效手段?个人的住家是否就是"地图上的绿洲"?家是不是人们最隐秘的堡垒,他们从这里获得未曾拥有的所有力量?带着对上述问题的思考,文章分析了四个充满创意的当代西班牙社会住宅案例——米拉多尔大楼,赛洛西大楼,马德里生物气候塔楼和巴塞罗那"海港圣母街大楼"——的概念、方案和技术手段,展现了居住空间及其与公共空间的关系的新前景:集体生活、个体性与市民性的实现,类型化与多样化,交往及交流空间,功能主义与可持续性,社会住宅与社会整合等。

关键词：当代社会住宅可持续性交往空间

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Description of the Factors Associated with Trigger Finger in Patients Treated at Petroleos Mexicanos “Pemex”

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Journal of Biosciences and Medicines 2023年第7期11卷 151-159页

作者： Fernando Barbosa-Villarreal Cuahutémoc Márquez-Espriella Rodrigo Dávila-Díaz Marco A. Cuervo-Vergara blanca Y. Arambula-Sánchez Alberto I. Cahuana-Quispe Victor A. Esquivel-Chávez Carlos E. García-Córdova Ana P. Campollo-López Mauricio Gutierrez-Alvarez Jesus R. García-Corral Alfredo Chama-Naranjo Daniel de Luna-Gallardo Ricardo A. Pulido-López Isaac F. Recio-España Esteban I. Campos-Serna Carlos I. Navarro-Delgadillo José C. Martínez-López Victor H. Avalos-Gómez Alejandro Cruz-Zarate Department of Plastic and Reconstructive Surgery Hospital Central Sur Petróleos Mexicanos Mexico City Mexico

Background: The trigger finger, also known as stenosing tenosynovitis of the flexor tendon, is a common cause of hand disability;This can result in significant limitations in certain daily living activities. It is possible to treat this condition with conservative or surgical methods. Methods: This is a retrospective, observational, cross-sectional and descriptive study. The source population consisted of all patients with a diagnosis of trigger finger who had been treated in the department of plastic and reconstructive surgery of our institution between 2020 and 2023. The primary objective of this study is to determine the prevalence and characterize the clinical and surgical characteristics of the population affected by trigger finger in our hospital. Results: The total population was 237 patients, of which 165 were women (70%) and 72 men (30%). The most affected hand was the right hand, with a total of 158 patients (67%). In the right hand, the middle finger was the most affected (45%). Of the 237 patients, 80 of them had obesity (34%), 86 had type 2 diabetes mellitus (36%), 95 had systemic arterial hypertension (40%). Open technique was performed in 190 (80%) patients, while percutaneous technique was performed in 47 (20%) of them. Conclusion: The female sex was twice as frequent, and the middle finger and thumb were the most affected. Most of the patients received surgical treatment with open approach and percutaneous approach in 20% of them.

关键词： Trigger Finger Tendinopathy

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脑内GABA代谢不足导致星形胶质细胞和少突胶质细胞功能广泛受损

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神经损伤与功能重建 2024年第9期19卷 F0003-F0003页

作者： Jens VAndersen Oana C Marian Filippa L Qvist Emil W Westi blanca I Aldana Arne Schousboe Anthony S Don Niels H Skotte Petrine Wellendorph 王晶(编译) Department of Drug Design and Pharmacology Faculty of Health and Medical SciencesUniversity of CopenhagenCopenhagenDenmark Charles Perkins Centre The University of SydneyCamperdownNew SouthWalesAustralia School of Medical Sciences The University of SydneyCamperdownNew SouthWalesAustralia 不详

神经代谢障碍性疾病琥珀酸半醛脱氢酶(SSADH)缺乏症会导致严重的神经化学失衡和严重的神经表现。该病的病因是SSADH酶功能丧失,导致主要抑制性神经递质γ-氨基丁酸(GABA)代谢受损。尽管已知酶缺乏的身份,但SSADH缺乏症的潜在病理机制仍... 详细信息

神经代谢障碍性疾病琥珀酸半醛脱氢酶(SSADH)缺乏症会导致严重的神经化学失衡和严重的神经表现。该病的病因是SSADH酶功能丧失,导致主要抑制性神经递质γ-氨基丁酸(GABA)代谢受损。尽管已知酶缺乏的身份,但SSADH缺乏症的潜在病理机制仍不清楚。为了揭示该病的新机制,我们在SSADH缺乏症的遗传小鼠模型(ALDH5A1基因敲除小鼠)中进行了脑蛋白表达、功能代谢和脂质组成的非靶向整合分析。我们的蛋白质组学分析显示存在明显的区域脆弱性,因为蛋白质改变主要在ALDH5A1基因敲除小鼠的海马体和大脑皮质中表现出来。这些区域显示出与氨基酸稳态、线粒体、胶质细胞功能和髓鞘形成相关的蛋白质异常表达。在急性分离的脑切片中进行稳定同位素示踪显示,葡萄糖的氧化代谢总体上得以维持,但ALDH5A1基因敲除小鼠大脑皮质的星形胶质细胞代谢活性有所下降。相比之下,在ALDH5A1基因敲除小鼠的大脑中观察到氧化性谷氨酰胺代谢能力增强,这可能是星形胶质细胞谷氨酰胺供应受损的神经元补偿。除了少突胶质细胞关键蛋白表达减少外,ALDH5A1基因敲除小鼠大脑中还发现富含髓鞘的神经鞘脂严重耗竭,表明髓鞘退化。综上所述,我们的研究表明星形胶质细胞和少突胶质细胞功能障碍与SSADH缺乏症病理密切相关,提示选择性靶向胶质细胞可能在该病的治疗中具有潜力。

关键词： SSADH缺乏症脑能量代谢胶质细胞谷氨酸/GABA-谷氨酰胺循环髓鞘

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