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Surgical site infection following pancreaticoduodenectomy in a referral cancer center in Mexico

24th International Papillomavirus Conference and Clinical Workshop

作者： Josefa Antonia Rodriguez Garcia Martha Lucia Serrano Lopez Liliana Galeano Petro Constanza Gomez Diana maria Palacios Ortiz maria mercedes bravo hernandez Alba Lucia Combita Rojas Instituto Nacional de Cancerologia Instituto Nacional de Cancerologia Instituto Nacional de Cancerologia Instituto Nacional de Cancerologia Fundacion Santa Fe Instituto Nacional de Cancerologia Instituto Nacional de Cancerologia

＜正＞Immune evasion in cancer can result from structural and functional alterations in HLA-1 molecules and from the local release of immunosuppressive *** of heterozygosity（LOH）in HLA（6p21.3）and B2-m（15q21）regions is associated with HLA-1 down regulation in tumours HLA-G,a no classical class I molecule,and IL-10 are implicated in immune evasion in cancer

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Hepatobiliary & Pancreatic Diseases International 2024年第5期23卷 502-508页

作者： Rodrigo Villaseñor-Echavarri Javier Melchor-Ruan mercedes Aranda-Audelo Gabriela Arredondo-Saldaña Patricia Volkow-Fernandez maria del Carmen Manzano-Robleda Alejandro E Padilla-Rosciano Diana Vilar-Compte Department of Infectious Diseases Instituto Nacional de CancerologíaAv.San Fernando 22Belisario Domínguez Secc 16TlalpanMexico CityMexico School of Medicine Universidad PanamericanaAugusto Rodin No.498Insurgentes MixcoacBenito JuárezMexico CityMexico Department of Digestive Tube and Hepatopancreatobiliary Tumors Instituto Nacional de CancerologíaAv.San Fernando 22Belisario Domínguez Secc 16TlalpanMexico CityMexico Department of Infectious Diseases Hospital Manuel Gea GonzálezCalz.de Tlalpan 4800Belisario Domínguez Secc 16TlalpanMexico CityMexico Gastrointestinal and Endoscopy Department Instituto Nacional de CancerologíaAv.San Fernando 22Belisario Domínguez Secc 16TlalpanMexico CityMexico

Background: Pancreaticoduodenectomy is the standard treatment for resectable periampullary cancer. Surgical site infections(SSI) are common complications with increased morbidity. The study aimed to describe the prevalence, risk factors, microbiology, and outcomes of SSI among patients undergoing pancreaticoduodenectomy. Methods: We conducted a retrospective study in a referral cancer center between January 2015 and June 2021. We analyzed baseline patient characteristics and SSI occurrence. Culture results and susceptibility patterns were described. Multivariate logistic regression was used to determine risk factors, proportional hazards model to evaluate mortality, and Kaplan-Meier analysis to assess long-term survival. Results: A total of 219 patients were enrolled in the study;101(46%) developed SSI. Independent factors for SSI were diabetes mellitus, preoperative albumin level, biliary drainage, biliary prostheses, and clinically relevant postoperative pancreatic fistula. The main pathogens were Enterobacteria and Enterococci. Multidrug-resistance rate in SSI was high but not associated with increased mortality. Infected patients had higher odds of sepsis, longer hospital stay and intensive care unit stay, and readmission rate. Neither 30-day mortality nor long-term survival was significantly different between infected and non-infected patients. Conclusions: SSI prevalence among patients undergoing pancreaticoduodenectomy was high and largely caused by resistant microorganisms. Most risk factors were related to preoperative instrumentation of the biliary tree. SSI was associated with greater risk of unfavorable outcomes;however, survival was unaffected.

关键词： Surgical site infection Pancreaticoduodenectomy Pancreatic cancer Endoscopic biliary drainage Biliary prosthesis

A comprehensive review of genetic causes of obesity

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World Journal of Pediatrics 2024年第1期20卷 26-39页

作者： Marcio Jose Concepcion-Zavaleta Juan Eduardo Quiroz-Aldave maria del Carmen Durand-Vasquez Elman Rolando Gamarra-Osorio Juan del Carmen Valencia de la Cruz Claudia mercedes Barrueto-Callirgos Susan Luciana Puelles-Leon Elena de Jesus Alvarado-Leon Frans Leiva-Cabrera Francisca Elena Zavaleta-Gutierrez Luis Alberto Concepcion-Urteaga Jose Paz-Ibarra Universidad Cientifica del Sur Bolivar 2150 AvenuePueblo Libre15084LimaPeru Division of Medicine Hospital de Apoyo ChepénChepenPeru Division of Family Medicine Hospital de Apoyo ChepénChepenPeru Division of Endocrinology Hospital Victor Lazarte EchegarayTrujilloPeru Division of Pediatrics Hospital de Apoyo ChepenChepenPeru Division of Internal Medicine Hospital de Apoyo ChepenChepenPeru Division of Genetics Universidad Nacional de TrujilloTrujilloPeru Division of Neonatology Hospital Belen de TrujilloTrujilloPeru Division of Internal Medicine Universidad Nacional de TrujilloTrujilloPeru Department of Medicine School of MedicineUniversidad Nacional Mayor de San MarcosLimaPeru

Background Obesity is a multifactorial chronic disease with a high,increasing worldwide *** causes account for 7%of the cases in children with extreme *** sources This narrative review was conducted by searching for papers published in the PubMed/MEDLINE,Embase and SciELO databases and included 161 *** search used the following search terms:"obesity","obesity and genetics","leptin","Prader-Willi syndrome",and"melanocortins".The types of studies included were systematic reviews,clinical trials,prospective cohort studies,cross-sectional and prospective studies,narrative reviews,and case *** The leptin-melanocortin pathway is primarily responsible for the regulation of appetite and body ***,several important aspects of the pathophysiology of obesity remain *** causes of obesity can be grouped into syndromic,monogenic,and polygenic causes and should be assessed in children with extreme obesity before the age of 5 years,hyperphagia,or a family history of extreme obesity.A microarray study,an analysis of the melanocortin type 4 receptor gene mutations and leptin levels should be performed for this *** are three therapeutic levels:lifestyle modifications,pharmacological treatment,and bariatric *** Genetic study technologies are in constant development;however,we are still far from having a personalized approach to genetic causes of obesity.A significant proportion of the affected individuals are associated with genetic causes;however,there are still barriers to its approach,as it continues to be underdiagnosed.

关键词： Leptin Melanocortin Obesity Prader-Willi syndrome Precision medicine

COVID-19 pandemic and nurse teaching:Our experience

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World Journal of Clinical Cases 2022年第8期10卷 2657-2659页

作者： Juan Carlos Molina Ruiz Jose Luis Guerrero Orriach maria Luisa bravo Arcas Angela Montilla Sans RocioEscano Gonzalez Department of Anesthesia Hu Virgen De La VictoriaMalaga 29006Spain

In this letter to the editor,we would like to show in our hospital how our nurse team manage formation during coronavirus disease 2019 pandemic.

关键词： COVID-19 Anesthesia Critical care Nurses First wave Training

Helicobacter pylori CagA protein polymorphisms and their lack of association with pathogenesis

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World Journal of Gastroenterology 2010年第31期16卷 3936-3943页

作者： Nicole Acosta Andrés Quiroga Pilar Delgado María mercedes bravo Carlos Jaramillo Molecular Diagnostics and Bioinformatics Laboratory Biological Sciences DepartmentLos Andes University Infectious Agents and Cancer Research Group National Cancer Institute(Colombia)

AIM: To investigate Helicobacter pylori (H. pylori) CagA diversity and to evaluate the association between protein polymorphisms and the occurrence of gastric pathologies. METHODS: One hundred and twenty-two clinical isolates of H. pylori cultured from gastric biopsies obtained from Colombian patients with dyspepsia were included as study material. DNA extracted from isolates was used to determine cagA status, amplifying the C-terminal cagA gene region by polymerase chain reaction. One hundred and six strains with a single amplicon were sequenced and results were used to characterize the 3' variable region of the cagA gene. To establish the number and type of tyrosine phosphorylation motifs Glutamine acid-Proline-Isoleucine-Tyrosine-Alanine (EPI-YA) bioinformatic analysis using Amino Acid Sequence Analyzer-Amino Acid Sequence Analyzer software was conducted. Analysis of the association between the number of EPIYA motifs and the gastric pathology was performed using χ2 test and analysis of the presence of EPIYA-C motifs in relation to the pathology was made by logistic regression odds ratios. Comparisons among EPIYA types found and those reported in GenBank were performed using a proportion test in Statistix Analytical Software version 8.0. RESULTS: After amplification of the 3' of the cagA gene, 106 from 122 isolates presented a single amplicon and 16 showed multiple amplicons. As expected, diversity in the size of the cagA unique fragments among isolates was observed. The 106 strains that presented a single amplicon after 3' cagA amplification came from patients with gastritis (19 patients), atrophic gastritis (21), intestinal metaplasia (26), duodenal ulcer (22) and gastric cancer. DNA sequence analysis showed that the differences in size of 3' cagA unique fragments was attributable to the number of EPIYA motifs: 1.9% had two EPIYA motifs, 62.3% had three, 33.0% had four and 2.8% had five motifs. The majority of tested clinical strains (62.3%) were found to harbor

关键词： Helicobacter pylori CagA-protein polymorphisms Molecular characterization Bioinformatic analysis Pathogenesis Cancer

Serum levels of the novel adipokine isthmin-1 are associated with obesity in pubertal boys

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World Journal of Pediatrics 2023年第9期19卷 864-872页

作者： Francisco Javier Ruiz‑Ojeda Augusto Anguita‑Ruiz maria C.Rico Rosaura Leis Gloria Bueno Luis A.Moreno mercedes Gil‑Campos Ángel Gil Concepción M.Aguilera Department of Biochemistry and Molecular Biology Ⅱ School of PharmacyUniversity of GranadaGranadaSpain Instituto de Investigación Biosanitaria Ibs.GRANADA 18012 GranadaSpain Institute of Nutrition and Food Technology“JoséMataix” Center of Biomedical ResearchUniversity of GranadaAvda.del Conocimiento S/N.18016 ArmillaGranadaSpain RG Adipocytes and Metabolism Institute for Diabetes and ObesityHelmholtz Center Munich85764 MunichGermany Barcelona Institute for Global Health ISGlobal08003 BarcelonaSpain CIBEROBN (Physiopathology of Obesity and Nutrition CB12/03/30038)Institute of Health Carlos Ⅲ(ISCⅢ)28029 MadridSpain Unit of Investigation in Human Nutrition Growth and Development of Galicia(GALINUT)University of Santiago de Compostela(USC)Santiago de CompostelaSpain Pediatric Nutrition Research Group Institute of Sanitary Research of Santiago de Compostela(IDIS)CHUS-USC15706 Santiago de CompostelaSpain Unit of Pediatric Gastroenterology Hepatology and NutritioPediatric ServiceUniversity Clinical Hospital of Santiago(CHUS)15706 Santiago de CompostelaSpain GENUD Research group Institute of Sanitary Research of Aragón(IIS Aragón)University of ZaragozaZaragozaSpain Instituto Agroalimentario de Aragón(IA2) Universidad de Zaragoza-CITAZaragozaSpain Unit of Pediatric Endocrinology University Clinical Hospital Lozano Blesa50009 ZaragozaSpain Metabolism and Investigation Unit Reina Sofa University HospitalMaimónides Institute of Biomedicine Research of Córdoba(IMIBIC)University of Córdoba14071 CórdobaSpain

Objectives To evaluate whether there is an association between the serum levels of the novel insulin-like adipokine isthmin-1(ISM1)and obesity-related phenotypes in a population of Spanish children and to investigate the plausible molecular alterations behind the alteration of the serum levels of this protein in children with *** The study population is a sub-cohort of the PUBMEP research project,consisting of a cross-sectional population of 119 pubertal children with overweight(17 boys,19 girls),obesity(20 boys,25 girls),and normal weight(17 boys,21 girls).All subjects were classified into experimental groups according to their sex,obesity,and insulin resistance(IR)*** were counted anthropometry,glucose and lipid metabolism,inflammation and cardiovascular biomarkers as well as isthmin-1(ISM1)serum *** population was intended as a discovery population to elucidate the relationship between obesity and ISM1 levels in ***,the study population had blood whole-genome DNA methylation examined,allowing deepening into the obesity–ISM1 molecular *** Higher serum ISM1 levels were observed in boys with obesity than in normal weight(P=0.004)and overweight(P=0.007)***1 serum levels were positively associated with body mass index(BMI)Z-score(P=0.005)and fat mass(P=0.058)and negatively associated with myeloperoxidase(MPO)(P=0.043)in *** we did not find associations between ISM1 serum levels and metabolic outcomes in girls,which may indicate a putative sexual dimorphism,fat mass was positively associated in all children,including boys and girls(P=0.011).DNA methylation levels in two-enhancer-related CpG sites of ISM1(cg03304641 and cg14269097)were associated with serum levels of ISM1 in *** ISM1 is associated with obesity in boys at the pubertal stage,elucidating how this protein might be of special relevance as a new biomarker of obesity in *** studies including a longitudina

关键词： Children Epigenetics Isthmin-1 Obesity Puberty

Gastric mucosa-associated lymphoid tissue lymphomas and Helicobacter pylori infection:A Colombian perspective

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World Journal of Gastroenterology 2012年第7期18卷 685-691页

作者： Sally Yepes maria mercedes Torres Carlos Saavedra Rafael Andrade Institute of Genetics Universidad Nacional de Colombia14490 Bogotá DCColombia Department of Pathology Fundación Santa Fe de Bogotá220246 Bogotá DCColombia Human Genetics Laboratory Universidad de los Andes4976 Bogotá DCColombia Faculty of Medicine Universidad Nacional de Colombia14490 Bogotá DCColombia

AIM:To assess the significance of chromosome translocation t(11;18)(q21;q21),B-cell lymphoma 10 (BCL-10) protein and Helicobacter pylori (***) infection in gastric mucosa-associated lymphoid tissue (MALT) lymphoma in ***:Fifty cases of gastric MALT lymphoma and their respective post-treatment follow-up biopsies were examined to assess the presence of the translocation t(11;18)(q21;q21) as identified by fluorescence in situ hybridization;to detect protein expression patterns of BCL10 using immunohistochemistry;and for evaluation of tumor histology to determine the correlation of these factors and resistance to *** ***:Infection with *** was confirmed in all cases of gastric MALT lymphoma in association with chronic *** eradication led to tumor regression in 66% of *** translocation t(11;18)(q21;q21) was not present in any of these cases,nor was there evidence of tumor transformation to diffuse large B-cell ***-four percent of the patients showed resistance to tumor regression,and within this group,7 cases,representing 14% of all those analyzed,were considered to be t(11;18)(q21;q21)-positive gastric MALT *** expression of BCL10 in the nucleus was associated with the presence of translocation and treatment *** that were considered unresponsive to therapy were histologically characterized by the presence of homogeneous tumor cells and a lack of plasmacytic *** cases exhibited higher cellular heterogeneity and a greater frequency of plasma ***:Both t(11;18)(q21;q21)-positive MALT lymphoma cases and those with nuclear BCL10 expression are considered resistant to *** *** is suggested that chronic antigenic stimulation is not a dominant event in resistant cases.

关键词： B细胞淋巴瘤哥伦比亚淋巴组织胃黏膜幽门螺杆菌感染胃癌染色体易位

Robot-assisted oncologic pelvic surgery with Hugo™robot-assisted surgery system:A single-center experience

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Asian Journal of Urology 2023年第4期10卷 461-466页

作者： Angelo Territo Alessandro Uleri Andrea Gallioli Josep maria Gaya Paolo Verri Giuseppe Basile Alba Farré Alejandra bravo Alessandro Tedde Óscar Rodríguez Faba Joan Palou Alberto Breda Department of Urology FundacióPuigvertAutonomous University of BarcelonaBarcelonaSpain

Objective To report the outcomes of intra-and extra-peritoneal robot-assisted radical prostatectomy(RARP)and robot-assisted radical cystectomy(RARC)with Hugo™robot-assisted surgery(RAS)system(Medtronic,Minneapolis,MN,USA).Methods Data of twenty patients who underwent RARP and one RARC at our institution between February 2022 and January 2023 were *** primary endpoint of the study was to report the surgical setting of Hugo™RAS system to perform RARP and *** secondary endpoint was to assess the feasibility of RARP and RARC with this novel robotic platform and report the *** Seventeen patients underwent RARP with a transperitoneal approach,and three with an extraperitoneal approach;and one patient underwent RARC with intracorporeal ileal *** intraoperative complications *** docking and console time were 12(interquartile range[IQR]7-16)min and 185(IQR 177-192)min for transperitoneal RARP,15(IQR 12-17)min and 170(IQR 162-185)min for extraperitoneal *** intraoperative complications *** patient submitted to extraperitoneal RARP had a urinary tract infection in the postoperative period that required an antibiotic treatment(Clavien-Dindo Grade 2).In case of transperitoneal RARP,two minor complications occurred(one pelvic hematoma and one urinary tract infection;both Clavien-Dindo Grade 2).Conclusion Hugo™RAS system is a novel promising robotic platform that allows to perform major oncological pelvic *** showed the feasibility of RARP both intra-and extra-peritoneally and RARC with intracorporeal ileal conduit with this novel platform.

关键词： Bladder cancer Prostate cancer Radical cystectomy Radical prostatectomy Robotic surgery

T follicular helper expansion and humoral-mediated rejection are independent of the HVEM/BTLA pathway

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Cellular & Molecular Immunology 2017年第6期14卷 497-510页

作者： Jose-Ignacio Rodriguez-Barbosa Carlos Fernandez-Renedo Ana maria bravo Moral Leo Biihler maria-Luisa del Rio Transplantation Immunobiology Section Institute of Biomedicine University of Leon and Castilla and Leon Regional Transplantation Coordination Leon University Hospital Leon Spain Department of Veterinary Clinical Sciences University of Santiago de Compostela Veterinary Faculty Lugo Spain Visceral and Transplantation Surgery Department of Surgery University Hospitals of Geneva and Faculty of Medicine Geneva Switzerland

The molecular pathways contributing to humoral-mediated allograft rejection are poorly defined. In this study, we assessed the role of the herpesvirus entry mediator/B- and T-lymphocyte attenuator （HVEM/BTLA） signalling pathway in the context of antibody-mediated allograft rejection. An experimental setting was designed to elucidate whether the blockade of HVEM/BTLA interactions could modulate de novo induction of host antidonor-specific antibodies during the course of graft rejection. To test this hypothesis, fully allogeneic major histocompatibility complex-mismatched skin grafts were transplanted onto the right flank of recipient mice that were treated with isotype control, anti-CD40L or modulatory antibodies of the HVEM/BTLA signalling pathway. The frequencies of CD4 T follicular helper （Tfh） cells （B220-, CD4＋ CXCR5＋ PD-lhigh）, extrafollicular helper cells （B220-, CD4＋ CXCR5- PD-1＋ and PD-1-） and germinal centre （GC） B cells （B220＋Fas＋ GL7＋） were analysed by flow cytometry in draining and non-draining lymph nodes at day 10 post transplantation during the acute phase of graft rejection. The host antidonor isotype-specific humoral immune response was also assessed. Whereas blockade of the CD40/CD40L pathway was highly effective in preventing the allogeneic humoral immune response, antibody-mediated blockade of the HVEM/BTLA-interacting pathway affected neither the expansion of Tfh cells nor the expansion of GC B cells. Consequently, the course of the host antidonor antibody-mediated response proceeded normally, without detectable evidence of impaired development. In summary, these data indicate that HVEM/BTLA interactions are dispensable for the formation of de novo host antidonor isotype-specific antibodies in transplantation.

关键词： BTLA (CD272) humoral immunity HVEM (TNFRSF14, CD270) T follicular helper cells transplantation