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Duodenal biopsy may be avoided when high transglutaminase antibody titers are present

World Journal of gastroenterology 2009年第38期15卷 4775-4780页

作者： Santiago Vivas jose g ruiz de morales Sabino Riestra Laura Arias Dolores Fuentes Noemi Alvarez Sara Calleja Mercedes Hernando Blanca Herrero Javier Casqueiro Luis Rodrigo department of gastroenterology Hospital de León Institute of Biomedicine University of León Immunology Section Hospital de León department of gastroenterology Hospital Universitario Central de Asturias department of Pathology Hospital de León department of Pediatrics Hospital de León Faculty of Biology and Environmental Sciences University of León

AIM:To evaluate the predictive value of tissue transglutaminase (tTg) antibodies for villous atrophy in adult and pediatric populations to determine if duodenal biopsy can be ***: A total of 324 patients with celiac disease (CD; 97 children and 227 adults) were recruited prospectively at two tertiary centers. Human IgA class anti-tTg antibody measurement and upper gastrointestinal endoscopy were performed at diagnosis. A second biopsy was performed in 40 asymptomatic adults on a gluten-free diet (gFD) and with normal tTg ***: Adults showed less severe histopathology (26% vs 63%, Pg antibody titers than children. Levels of tTg antibody correlated with Marsh type in both populations (r=0.661, Pgistic regression revealed that only tTg antibody was an independent predictor for Marsh type 3 lesions, but clinical presentation type and age were not. A cut-off point of 30 U tTg antibody yielded the highest area under the receiver operating characteristic curve (0.854). Based on the predictive value of this cut-off point, up to 95% of children and 53% of adults would be correctly diagnosed without biopsy. despite gFDs and decreased tTg antibody levels, 25% of the adults did not recover from villous atrophy during the second year after ***: Strongly positive tTg antibody titers might be sufficient for CD diagnosis in children. However, duodenal biopsy cannot be avoided in adults because disease presentation and monitoring are different.

关键词： Biopsy Celiac disease Diagnosis Duodenum Transglutaminases

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Transplant-associated thrombotic microangiopathy:a rare but deadly complication post orthotopic heart transplantation

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Journal of geriatric Cardiology 2022年第6期19卷 485-486页

作者： jose ruiz-morales Maedeh ganji Rohan goswami Division of Advanced Heart Failure&Transplant Cardiology Mayo ClinicJacksonvilleFloridaUSA Cardiology department University of FloridaJacksonvilleFloridaUSA

Thrombotic microangiopathy(TMA)is potentially life-threatening condition caused by small-vessel microthrombi and is associated with schistocyte formation,low platelets and end-organ damage that may not be reversible.[1,2]As a life-threatening condition,TMA recognition in hospitalized patients after organ transplantation is key to improving ***-associated TMA(TATMA)can occur after both solid organ or hematopoietic stem cell transplantation and often mimics other disease processes such as thrombotic throm-bocytopenic purpura(TTP)with similar constellation of symptoms during *** present a rare case of a patient with TATMA after orthotopic heart transplantation.

关键词： thrombotic microangiopathy orthotopic

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Acute lymphocytic myocarditis

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Journal of geriatric Cardiology 2018年第7期15卷 527-528页

作者： Maedeh ganji jose ruiz-morales Saif Ibrahim Cardiology department University of Florida Jacksonville FL USA Internal Medicine department University of Florida Jacksonville FL USA Interventional Cardiology department University of Alabama-Birmingham Birmingham AL USA

Myocarditis is an inflammatory disease of the myocardium. The clinical presentation of myocarditis may range from subclinical to sudden death. The incidence of fatal myocarditis, which often presents with sudden or rapid death, has been estimated at 0.15/100.000 in the general population and is highest in infants and young adults （but may affect any age group）. However, diffuse myocarditis in autopsies of sudden death is 〈 2% in adult.

关键词： Cardiomyopathy Myoearditis Heart attack STEMI Sudden cardiac death

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Anterior myocardial pseudoinfarction in a patient with diabetic ketoacidosis

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Journal of geriatric Cardiology 2018年第3期15卷 238-240页

作者： jose ruiz-morales Catarina Canha Farah Al-Saffar Saif Ibrahim Internal medicine department University of Florida Jacksonville FL USA Cardiology department Mayo Clinic Scottsdale AZ USA Cardiology department University of Florida Jacksonville FL USA

Diabetic ketoacidosis remains one of the most serious complications of diabetes mellitus. Among its precipitating factors is myocardial ischemia, responsible for 1% of the cases of diabetic *** Diabetic ketoacidosis both with and without hyperkalemia has been reported to mimic a myocardial infarction pattem on ECg with ST segment elevation, described as pseudoinfarction pattern. Thus, it is important to raise awareness among physicians, as subjecting patients to invasive medical management can be avoided. We present a case of a 47-year-old female with diabetic ketoacidosis and hyperkalemia with initial ECg findings of ST segment elevation, but an urgent left heart catheterization revealed non-obstructive coronary disease.

关键词： Anterior STEMI DKA Heart attack Pseudoinfarction STEMI

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Invasive versus non-invasive hemodynamic monitoring of heart failure patients and their outcomes

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Journal of geriatric Cardiology 2022年第4期19卷 315-318页

作者： Fadi Kandah Pooja Dhruva Raj Shukla Maedeh ganji Carlos Palacio Emil Missov jose ruiz-morales Internal Medicine University of Florida College of Medicine-JacksonvilleJacksonvilleFloridaUSA Division of Cardiology University of Florida College of Medicine-JacksonvilleJacksonvilleFloridaUSA

Acute decompensated heart failure(HF)is the most common cause of hospital ad-mission in patients older than 65 *** length of hospital stay is about 5-6 days and with a frequent number of hospital readmission rates of 25%to 50%at 30 days and 6-12 months,respect-ively.[1]Treatment options are vast and depend on certain patient characteristics,including hemody-namics,which drive the acute management.A pop-ular modality to assess hemodynamics in acute HF is the right heart catheterization(RHC).While in-vasive,the use of RHC gives providers the oppor-tunity to evaluate values that directly contribute to the management of the *** numbers can calculate the cardiac output as well as help establish the underlying etiology of the patient’s symptoms and guide therapy.

关键词： patients acute Acute

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Tricks and tips in pancreatoduodenectomy

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World Journal of gastrointestinal Oncology 2014年第9期6卷 344-350页

作者： Anna Pallisera Rafael morales jose Manuel Ramia department of Surgery Hospital Son Llatzer HPB Unit Department of SurgeryHospital Universitario de Guadalajara

Pancreaticoduodenectomy(PD) is the standard surgical treatment for tumors of the pancreatic head,proximal bile duct,duodenum and ampulla,and represents the only hope of cure in cases of *** its initial description in 1935 by Whipple et al,this complex surgical technique has evolved and undergone several *** review three key issues in PD:(1) the initial approach to the superior mesenteric artery,known as the artery-first approach;(2) arterial complications caused by anatomic variants of the hepatic artery or celiac artery stenosis;and(3) the extent of lymphadenectomy.

关键词： Pancreas Pancreaticoduodenectomy Artery-first Surgery Lymphadenectomy Celiac axis Hepatic artery

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Predicting the clothing insulation through machine learning algorithms:A comparative analysis and a practical approach

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Building Simulation 2024年第5期17卷 839-855页

作者： Pablo Aparicio-ruiz Elena Barbadilla-Martin jose guadix Jesus Munuzuri grupo de Ingenieria de Organizacion Escuela Tecnica Superior de IngenieriaUniversidad de SevillaCamino de los Descubrimientos S/N41092SevilleSpain

Since indoor clothing insulation is a key element in thermal comfort models,the aim of the present study is proposing an approach for predicting it,which could assist the occupants of a building in terms of recommendations regarding their *** that,a systematic analysis of input variables is exposed,and 13 regression and 12 classification machine learning algorithms were developed and *** results are based on data from 3352 questionnaires and 21 input variables from a field study in mixed-mode office buildings in *** temperature at 6 a.m.,indoor air temperature,indoor relative humidity,comfort temperature and gender were the most relevant features for predicting clothing *** comparing machine learning algorithms,decision tree-based algorithms with Boosting techniques achieved the best *** proposed model provides an efficient method for forecasting the clothing insulation level and its application would entail optimising thermal comfort and energy efficiency.

关键词： clothing insulation simulation adaptive thermal comfort behavioural adaptive actions machine learning

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geodesic Vulnerability Approach for Identification of Critical Buses in Power Systems

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Journal of Modern Power Systems and Clean Energy 2021年第1期9卷 37-45页

作者： Jesus Beyza Eduardo garcia-Paricio Hector F.ruiz jose M.Yusta Instituto Tecnologico de Morelia Avenida Tecnologico 1500Lomas de Santiaguito58120Mexico the department of Electrical Engineering University of ZaragozaC/Maria de Luna 350018Spain

One of the most critical issues in the evaluation of power systems is the identification of critical buses. For this purpose, this paper proposes a new methodology that evaluates the substitution of the power flow technique by the geodesic vulnerability index to identify critical nodes in power *** methods are applied comparatively to demonstrate the scope of the proposed approach. The applicability of the methodology is illustrated using the IEEE 118-bus test system as a case study. To identify the critical components, a node is initially disconnected, and the performance of the resulting topology is evaluated in the face of simulations for multiple cascading faults. Cascading events are simulated by randomly removing assets on a system that continually changes its structure with the elimination of each component. Thus, the classification of the critical nodes is determined by evaluating the resulting performance of 118 different topologies and calculating the damaged area for each of the disintegration curves of cascading failures. In summary, the feasibility and suitability of complex network theory are justified to identify critical nodes in power systems.

关键词： Power system critical node complex network theory cascading failure load flow

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Quantification of the Mixture of Hydrothermal and Fresh Water in Tectonic Valleys

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Journal of Earth Science 2020年第5期31卷 1007-1015页

作者： Janete Moran-Ramirez jose Ivan morales-Arredondoc Maria Aurora Armienta-Hernandez jose Alfredo Ramos-Leal National Council of Science and Technology National Autonomous University of MexicoInstitute of GeophysicsScientific Research CircuitUniversity CityCoyoacan 04150Mexico CityMexico National Autonomous University of Mexico Institute of GeophysicsUniversity CampusMexico CityMexico Potosino Institute for Scientific and Technological Research 78216 San Luis PotosiS.L.P.Mexico

This study was conducted to identify the origin, hydrogeochemical processes and evolution of groundwater in a tectonic valley. This study was carried out with the aim of quantifying the proportions of groundwater flows contributing to the water chemistry abstracted in a zone of convergence favored by the presence of active faults. The study area is located in the Trans-Mexican Volcanic Belt. End members methodology was applied to identify the mixing of hydrothermal with fresh groundwater, where changes in the aquifer geology result in distinct groundwater chemical signatures. Ternary mixing was quantified using conservative elements. Moreover, other evolutionary processes, such as ion exchange and silicate weathering occur due to changes in the geology of the area. In ternary mixing, each of the end members is associated with the lithology through which it circulates. The local flow contributes 70% of the water to the system, the intermediate flow contributes 14%, and the regional flow contributes 16%. Three types of water are produced: Na-HCO3, due to the interaction of water with volcanic rocks of rhyolitic composition, Na-Mg-HCO3, due to the interaction of water with volcanic rocks of basaltic-andesite composition, and Ca-HCO3, due to the interaction of water with sedimentary calcareous rocks.

关键词： hydrogeochemistry ternary mixing end members conservative elements local flow Mexico

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Intense pulsed light‑based treatment for the improvement of symptoms in glaucoma patients treated with hypotensive eye drops

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Eye and Vision 2024年第2期10卷 12-21页

作者： jose Maria Martinez‑de‑la‑Casa Carlos Oribio‑Quinto Almudena Milans‑del‑Bosch Pilar Perez‑garcia Laura morales‑Fernandez Javier garcia‑Bella jose Manuel Benitez‑del‑Castillo Julian garcia‑Feijoo David P.Pinero Ophthalmology Unit Department of Ophthalmology and ORLFaculty of MedicineHospital Clinico San-CarlosUniversidad Complutense de MadridInstituto de Investigacion Sanitaria del Hospital Clinico San-Carlos(IdISSC)28040 MadridSpain department of Immunology Ophthalmology and ORLSchool of MedicineInstituto de Investigaciones Oftalmologicas Ramon CastroviejoUniversidad Complutense de MadridMadridSpain department of Optics Pharmacology and AnatomyUniversity of AlicanteAlicanteSpain

Background:Ocular surface disease in glaucoma patients is a significant ocular co-morbidity that can affect 40%to 59%of these patients *** current study was aimed at evaluating the potential clinical benefit of an intense pulsed light(IPL)-based treatment in glaucomatous patients with ocular surface disease due to prolonged hypotensive eyedrop *** our knowledge,this is the first series analyzing the therapeutic effect of this treatment option in this type of ***:This non-comparative prospective case series study enrolled a total of 30 glaucoma patients ranging in age from 57 to 94 years old and treated with hypotensive eyedrops for years with dry eye *** patients received four sessions of IPL treatment using the Optima IPL system(Lumenis,Yokneam,Israel)adjusted to the official optimized Lumenis *** in symptomatology,corneal staining,conjunctival hyperemia,non-invasive break-up time(NIBUT),tear osmolarity,tear meniscus height(TMH),meiboscore and meibomian gland expressibility was analyzed after ***:Statistically significant reductions were observed after IPL treatment in the symptomatology scores measured with different questionnaires[ocular surface disease index(OSDI),standard patient evaluation of eye dryness(SPEED)and symptom assessment questionnaire in dry eye(SANde)]as well as with the visual analogue scale(Pge in OSDI was−15.0±11.3.A significant reduction was found after treatment in the corneal staining score(Pgnificant reduction was found in tear film meniscus height(P=0.012),as well as in tear film osmolarity(P=0.001).A significant reduction was also found in meibomian gland expressibility(P=0.003),changing the percentage of grade 3 eyes from 44.4%before IPL to 17.2%after ***:IPL therapy combined with meibomian gland expression(MgX)seems to be an effective option to improve symptomatology in glaucomatous patients with ocular surface diseas

关键词： glaucoma Intense pulsed light Dry eye Meibomian glands

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