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Gastrointestinal stromal tumors:a multidisciplinary challenge

World Journal of Gastroenterology 2018年第18期24卷 1925-1941页

作者： Juan manuel Sanchez-Hidalgo manuel duran-martinez Rafael Molero-Payan Sebastian Rufian-Pena Alvaro Arjona-Sanchez Angela Casado-Adam Antonio Cosano-Alvarez Javier Briceno-Delgado Department of General and Digestive Surgery Reina Sofia University HospitalAvda.Menéndez Pidal s/nCordoba 14004Spain Department of Intern Medicine Reina Sofia University HospitalAvda.Menéndez Pidal s/nCordoba 14004Spain Lipids and Atherosclerosis Research Unit IMIBIC/Hospital Universitario Reina Sofía/Universidad de CórdobaCordoba 14004Spain

Gastrointestinal stromal tumors(GISTs) are the most common mesenchymal tumors located in the alimentary tract. Its usual manifestation is gastrointestinal bleeding. However, small asymptomatic lesions are frequently detected as incidental finding. Characteristically, most GISTs(> 95%) are positive for the KIT protein(CD117) by IHC staining and approximately 80%-90% of GISTs carry a mutation in the c-KIT or PDGFRA genes. Mutational analysis should be performed when planning adjuvant and neoadjuvant therapy, due to its possible resistance to conventional treatment. The arise of tyrosine kinase inhibitor has supposed a revolution in GISTs treatment being useful as adjuvant, neoadjuvant or recurrence disease treatment. That is why a multidisciplinary approach to this disease is required. The correct characterization of the tumor at diagnosis(the diagnosis of recurrences and the evaluation of the response to treatment with tyrosine kinase inhibitors) is fundamental for facing these tumors and requires specialized Endoscopist, Radiologists and Nuclear Medicine Physician. Surgery is the only potentially curative treatment for suspected resectable GIST. In the case of high risk GISTs, surgery plus adjuvantImatinib-Mesylate for 3 years is the standard treatment. Neoadjuvant imatinib-mesylate should be considered to shrink the tumor in case of locally advanced primary or recurrence disease, unresectable or potentially resectable metastasic tumors, and potentially resectable disease in complex anatomic locations to decrease the related morbidity. In the case of Metastatic GIST under Neoadjuvant treatment, when there are complete response, stable disease or limited disease progression, complete cytoreductive surgery could be a therapeutic option if feasible.

关键词： Gastrointestinal stromal tumors Surgery Oncology Radiology Endoscopy Nuclear medicine Pathology Disease management Tyrosine kinase inhibitors Gastroenterology

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Laser Wavelength Estimation Method Based on a High-Birefringence Fiber Loop Mirror

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Photonic Sensors 2019年第1期9卷 89-96页

作者： Ricardo I.ALVAREZ-TAMAYO Patricia PRIETO-CORTES manuel duran-SANCHEZ Baldemar IBARRA-ESCAMILLA Antonio BARCELATA-PINZON Evgeny A.KUZIN Faculty of Physical-Mathematical Sciences CONACYT-Universidad Autonoma de Nuevo LeonSan Nicolas de los Garza 66451Mexico Faculty of Physical-Mathematical Sciences Universidad Autonoma de Nuevo LednSan Nicolas de los Garza 66451 Mexico Optics department CONA CYT-Instituto Nacional de AstrofisieaOptica y EleetronieaTonantzintla 72480Mexico Optics department Instituto Nacional de AstrofisicaOptica y ElectronicaTonantzintla 72480Mexico Mechatronics division Universidad Tecnologica de PueblaPuebla 72300Mexico

A simple method for the estimation of the wavelength of a fiber laser system is proposed. The method is based on the use of a high-birefringence-fiber loop mirror(HBFLM).The HBFLM exhibits a periodic transmission/reflection spectrum whose spectral characteristics are determined by the length and temperature of the high-birefringence fiber(HBF).Then,by the previous characterization of the HBFLM spectral transmission response,the central wavelength of the generated laser line can be *** using a photodetector,the *** of the laser line is estimated during an HBF temperature scanning by measuring the temperature at which the maximum transmitted power of the HBFLM is *** proposed method is demonstrated in a linear cavity tunable Er/Yb fiber *** method is a reliable and low-cost alternative for laser wavelength determination in short wavelength ranges without the use of specialized and expensive equipment.

关键词： Wavelength meter fiber lasers fiber optical loop mirror high-birefringence fiber

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Clinical and prognostic implications of delirium in elderly patients with non–ST-segment elevation acute coronary syndromes

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Journal of Geriatric Cardiology 2019年第2期16卷 121-128页

作者： Miquel Vives-Borras manuel martinez-Selles Albert Ariza-Sole Maria T.Vidan Francesc Formiga Hector Bueno Juan Sanchis Oriol Alegre Albert duran-Cambra Ramon Lopez-Palop Emad Abu-Assi Alessandro Sionis LONGEVO-SCA Investigators Department of Cardiology Hospital de la Santa Creu i Sant PauInstitute of Biomedical Research I1B Sant PauCIBERCVUniversitat Autonoma de BarcelonaBarcelonaSpain department of Cardiology Hospital General Universitario Gregorio MarahonC1BERCVUniversidad ComplutenseUniversidad EuropeaMadridSpain Hospital Universitari de Bellvitge L'Hospitalet de LlobregatBarcelonaSpain Hospital General Universitario Gregorio Maranon IiSGMCIBERFESUniversidad ComplutenseMadrid.Spain Hospital Doce de Octubre Centro Nacional de Investigaciones CardiovascularesMadridSpain Hospital Clinico de Valencia INCLIVAUniversidad de ValenciaCIBERCVSpain Hospital Universitario San Juan AlicanteSpain Hospital Alvaro Cunqueiro VigoSpain 不详

Background Elderly patients with non-ST-segment elevation acute coronary syndromes(NSTE-ACS)may present delirium but its clinical relevance is *** study aimed at detennining the clinical associated factors,and prognostic implications of delirium in old-aged patients admitted for *** LONGEVO-SCA is a prospective multicenter registry including unselected patients with NSTE-ACS aged>80 *** variables and a complete geriatric evaluation were assessed during *** association between delirium and 6-month mortality was assessed by a Cox regression model weighted for a propensity score including the potential confounding *** also analysed its association with 6-month bleeding and cognitive or functional *** Among 527 patients included,thirty-seven(7%)patients presented delirium during the *** was more frequent in patients with dementia or depression and in those from nursing homes(27.0%vs.3.1%,24.3%vs.11.6%,and 11.1%V5.2.2%,respectively;all P<0.05).Delirium was significantly associated with in-hospital infections(27.0%vs.5.3%,P<0.001)and usage of diuretics(70.3%vs.49.8%,P=0.02).Patients with delirium had longer hospitalizations[median 8.5(5.5-14)vs.6.0(4.0-10)days,P=0.02]and higher incidence of 6-month bleeding and mortality(32.3%vs.10.0%and 24.3%vs.10.8%,respectively;both P<0.05)but similar cognitive or functional *** was independently associated with 6-month mortality(HR=1.47,95%CI:1.02-2.13,P=0.04)and 6-month bleeding events(OR=2.87;95%CI:1.98-4」6,P<0.01).Conclusions In-hospital delirium in elderly patients with NSTE-ACS is associated with some preventable risk factors and it is an independent predictor of 6-month mortality.

关键词： Acute coronary syndromes Delirium Prognosis The elderly

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Combination of squamous cell carcinoma antigen immunocomplex and alpha-fetoprotein in mid-and long-term prediction of hepatocellular carcinoma among cirrhotic patients

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World Journal of Gastroenterology 2021年第48期27卷 8343-8356页

作者： Antonio Gil-Gómez Ángela Rojas Chang-Hai Liu Rocio Gallego-duran Rocio Muñoz-Hernandez Giorgio Fassina Patrizia Pontisso Javier Ampuero manuel Romero-Gómez SeLiver Group Institute of Biomedicine of SevilleSeville 41013Spain CIBERehd Instituto de Salud Carlos IIIMadrid 28029Spain Mucosal Immunity Lab IRCCS Humanitas Research HospitalMilan 20089Italy Center of Infectious Diseases West China Hospital of Sichuan UniversityChengdu 610017Sichuan ProvinceChina State Key Laboratory of Biotherapy and Center of Infectious Diseases West China HospitalChengdu 610017Sichuan ProvinceChina Life Biotechnology Padua UniversityVenice 30175Italy Department of Clinical and Experimental Medicine University of PadovaPadova 35123Italy UCM Digestive Diseases Virgen del Rocío University HospitalSeville 41014Spain

BACKGROUND The combination of alpha-fetoprotein(AFP)and squamous cell carcinoma antigen immunocomplex(SCCA-IgM)have been proposed for its use in the screening of hepatocellular carcinoma(HCC).Current screening programs for all cirrhotic patients are controversial and a personalized screening is an unmet need in the precision medicine *** To determine the role of the combination of SCCA-IgM and AFP in predicting mid-and long-term appearance of *** Two-hundred and three cirrhotic patients(Child A 74.9%,B 21.2%,C 3.9%)were followed-up prospectively every six months to screen HCC by ultrasound and AFP according to European Association for the Study of the Liver *** estimation cohort was recruited in Italy(30.5%;62/203)and validation cohort from Spain(69.5%;141/203).Patients underwent to evaluate SCCA-IgM by enzyme-linked immunosorbent assay(Hepa-IC,Xeptagen,Italy)and AFP levels at *** were followed-up for 60 mo,being censored at the time of the appearance of *** There were 10.8%and 23.1%of HCC development at two-and five-years *** with HCC showed higher levels of SCCA-IgM than those without it(425.72±568.33 AU/mL vs 195.93±188.40 AU/mL,P=0.009)during the fiveyear *** multivariate analysis,after adjusting by age,sex,aspartate transaminase and Child-Pugh,the following factors were independently associated with HCC:SCCA-IgM[Hazard ratio(HR)=1.001,95%CI:1.000-1.002;P=0.003],AFP(HR=1.028,95%CI:1.009-1.046;P=0.003)and creatinine(HR=1.56495%CI:1.151-2.124;P=0.004).The log-rank test of the combination resulted in 7.488(P=0.024)in estimation cohort and 11.061(P=0.004)in the validation cohort,and a 100%of correctly classified rate identifying a low-risk group in both cohorts in the two-year *** We have constructed a predictive model based on the combination of SCCA-IgM and AFP that provides a new HCC screening method,which could be followed by tailored HCC surveillance for individual patients,esp

关键词： Squamous cell carcinoma antigen Hepatocellular carcinoma prediction Precision medicine Stratification of cirrhotic patient

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Management of Complex Wounds with Dermal Substitute Assisted by a Negative Pressure System

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Modern Plastic Surgery 2023年第4期13卷 95-105页

作者： Cuahutémoc Márquez Espriella Ruiz Garza Jorge Gerardo Barbosa Villarreal Fernando Dávila Díaz Rodrigo Cuervo Vergara Marco Antonio Campollo López Ana Priscila Gutierrez Alvarez Mauricio Chama Naranjo Alfredo García Corral Jesús Ricardo Pérez Benítez Omar Alberto Pulido López Ricardo Alberto Jaimes duran Edwing Michel Garibaldi Bernot Mauro Cortes Aguilar Carlos manuel García Córdova Carlos Emiliano Camacho Rodriguez Hayah Camacho Rodriguez Hayah martinez Villalobos Claudia Nallely Ochoa Contreras Erick Cesar Randall Cruz Soto Herrera Lozano Luis Arturo Department of Plastic and Reconstructive Surgery Hospital Central Sur Petróleos Mexicanos Mexico City Mexico

Introduction: The standard treatment for complex wound care is autografting. The advent of dermal substitutes has provided a novel tool for the preparation of the bed to be grafted. However, most types of dermal matrices require the application of a skin graft a second time. Currently, other strategies have been developed to improve the vascularization process, such as negative pressure wound therapy (NPWT), which has been reported to reduce the time required for vascular growth and dermal matrix integration and thus achieve a shorter waiting period for autologous graft application. The present study aims to evaluate the effectiveness and safety of dermal matrix management associated with NPWT in the treatment of complex wounds. Methods: Seven patients with a diagnosis of complex wounds were enrolled in this study between July 1, 2015, and June 31, 2016. After debridement and having an adequate wound bed, patients who met the criteria for the application of combined therapy were treated with dermal substitutes and a negative pressure system. The percentage of graft integration into the wound bed, complications, length of hospital stay, and duration of therapy were analyzed. Results: The mean age was 42.5 ± 16 (39 - 54) years old;three women and four men were included in the study. The approximate size of skin loss was 120.7 ± 75 cm2 (25 - 250 cm2). The combined therapy of dermal matrix plus NPWT was instituted in all cases for a period of 14 days. There were no complications, with 100% graft integration in 6 of 7 cases. Patients were discharged after a mean hospital stay of 5.4 days. Conclusions: This study demonstrates that the utilization of combined dermal matrix plus NPWT therapy can be performed safely and effectively in patients with complex wounds with low complication rates and a short hospital stay.

关键词： Negative Pressure Wound Therapy Complex Wound Dermal Matrix Wound Therapy

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Efficacy of Isotonic Seawater Solution on Inflammation of the Ocular Surface in Matrix Metalloproteinase MMP-9-Positive Dry Eye Disease Patients

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Open Journal of Ophthalmology 2020年第3期10卷 221-229页

作者： Diaz-Llopis manuel Pinazo-duran Maria Dolores Diaz-Guiñon Loreto Rahhal-Ortuño Miriam Gallego-Pinazo Roberto Dolz-Marco Rosa Diaz-Guiñon Teresa Diaz Maria Romero Francisco Javier University of Valencia Valencia Spain Ophthalmology Unit Faculty of Medicine University of Valencia Valencia Spain Molecular Ophthalmology Unit Faculty of Medicine University of Valencia Valencia Spain Consellería de Sanitat (Valencian Regional Health Ministry) Valencian Autonomous Government Valencia IOVA-Valencia Ophthalmology Institute Valencia Spain Doctor Peset University Hospital Valencia Spain Santiago Grisolía Eye Research Laboratory FISABIO Valencia Spain Department of Ophthalmology La Fe Hospital Valencia Spain IMED Hospital Valencia Spain

Purpose: Prospective study to evaluate the anti-inflammatory efficacy of isotonic seawater solution on metalloproteinase 9 (MMP-9) levels in the tears of patients with dry eye disease (DED). Methods: A total of 50 patients were included, with the following dry eye criteria in both eyes: InflammaDry? test initially positive, ocular surface disease index (OSDI) score ≥ 12 and Results: The InflammaDry test was positive in 100% of the patients (n = 50) and in 100% (n = 100) of the eyes before treatment. In 14 (28%) patients the test became negative in both eyes, and in 15 (30%) it was negative in one of the eyes. In 43% (n = 43) of the positive eyes, MMP-9 became undetectable in the tear fluid following treatment with isotonic seawater. This change was statistically significant (p Conclusions: The washes with ophthalmic isotonic seawater solution have a significant impact on inflammation of the ocular surface in dry eye disease, with an ability to make MMP-9 levels negative in 43% of cases.

关键词： Dry Eye Inflammadry Test MMP-9 Ocular Surface Inflammation Ophthal-mic Isotonic Seawater Solution

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Epidemiology of Fingertip Injuries at South Central Hospital Petróleos Mexicanos “Pemex” with a Review of the Literature

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Journal of Biosciences and Medicines 2023年第6期11卷 182-195页

作者： Fernando Barbosa-Villarreal Cuahutémoc Márquez-Espriella Erika Barlandas-Quintana Ana Priscila Campollo-López Mauricio Gutiérrez-Álvarez Carlos Emiliano García-Córdova Jesús Ricardo García-Corral Alfredo Chama-Naranjo Ricardo Alberto Pulido-López Patricia Llizette López-Medellín Edgar Alan Guillen-Martínez Jonathan Steve Rodríguez-Alaníz Edwing Michel Jaimes-duran Carlos manuel Cortes-Aguilar Mauro Garibaldi-Bernot Omar Alberto Pérez-Benítez Miguel Eduardo Marín-Canto Luis Arturo Herrera-Lozano Héctor manuel Suarez-Ortega Alejandro Cruz-Zarate Department of Plastic and Reconstructive Surgery Hospital Central Sur Petróleos Mexicanos Mexico City Mexico

Background: The hand is an essential component for performing our daily tasks;as a result, injuries to the fingertip are frequently seen. Accurate evaluation and treatment of fingertip injuries are essential to avoiding long-term disability, job loss and psychological issues. No matter the injury classification system, maintaining finger length, regaining sensation, and improving appearance are the three main objectives of treatment. The objective of this research was to outline the epidemiology of fingertip injuries treated between 2021 and 2022 at a highly specialized referral hospital in Mexico City. Methodology: This investigation is cross-sectional, retrospective, and observational. From January 2021 to December 2022, 60 patients with a diagnosis of fingertip injury from the South Central Hospital “Pemex” were included. The descriptive statistical analysis was performed using SPSS29. Results: 60 patients were included, 27 (45%) were women and 33 (55%) were men. Allen’s classification was able to classify only 19 patients, of which 18 (94.7%) had a type 1 classification and one (5.26%) had a type 2 classification. 10% of patients experienced complications, which included 2 patients with surgical site infections (3.3%), 3 patients with persistent pain (5%), and 1 patient (1.6%) with graft rejection. Conclusions: There are currently insufficient epidemiological data on hand and wrist injuries and its effects on labor in Mexico. Fingertip injuries require particular care in order to prevent complications and long-term damage. The creation of national registries could help with the creation of reference manuals for the care of hand and wrist injuries in our nation.

关键词： Fingertip Fingertip Injuries Epidemiology

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Avocado Nutritional Diagnosis （Persea americana Mill.）＂Hass＂, Soil Fertility and Water Quality in Ocuituco, Morelos

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Journal of Chemistry and Chemical Engineering 2013年第11期7卷 1068-1073页

作者： Hector Sotelo-Nava Oscar Gabriel Villegas-Torres Martha Lilia Dominguez-Patint Elias Hernfindez Castro Agustin Damian Nava Antonio Rodrlguez-Martmez Carlos manuel Acosta-duran Maria Andrade-Rodriguez Iran Alia-Tej acal Faculty of Agricultural Sciences Universidad Aut6noma del Estado de Morelos Cuernavaca 62209 Mexico Faculty of Chemical Sciences and Engineering Universidad Aut6noma del Estado de Morelos Cuernavaca 62209 Mexico Unit of Agricultural and Environmental Sciences Universidad Autonoma de Guerrero Guerrero 39196 Mexico Engineering and Applied Science Research Center Universidad Autonoma del Estado de Morelos Cuernavaca 62209 Mexico

Morelos is the fourth in area cultivated and production volume of avocado. Of the 13 municipalities where it is farmed, Ocuituco represents 43.51% and Tetela del Volcán 27.53%. Despite being one of the main fruit species in Morelos, no information related to the fertility of the soil where it is grown, the quality of water available for irrigation and nutritional status of this important fruit for the state. The study was conducted in the municipality of Ocuituco which identified three agro-habitats taking into account climate, landform, soil type and altitude. In each agro-habitat were carried out soil sampling to determine the physical and chemical characteristics based on the Mexican Official Standard NOM-021-SEMARNAT-2000, the chemical quality of water for irrigation as described by Richards (1954) and crop nutrient status of avocado "Hass" according to the methodology described by Maldonado (2002). The soils had different physical and chemical characteristics, as well as the nutritional status of avocado trees in the three agro-habitats. The trees had excessive concentration of Cl, Cu and Zn. Indices of optimal percentage deviation expressed different nutritional requirements. The water used for irrigation was of low salinity and sodium content, so it can be used without restrictions.

关键词：土壤肥力鳄梨营养诊断水质美洲营养状况化学特性灌溉用水

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