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Endocranial Complications of Endoscopic Sinus Surgery: Learning from Experience

International Journal of Otolaryngology and Head & Neck Surgery 2014年第5期3卷 298-303页

作者： miguel armengot-carceller Rosa Hernandez-Sandemetrio ENT Department Surgery Department Valencia University General and University Hospital Valencia Spain ENT Department General and University Hospital Valencia Spain

Objectives: We critically reviewed our experiences in endocranial complications with Functional Endoscopic Sinus Surgery, and investigated the causes, prevention strategies and management. Methods: We conducted a retrospective study of endocranial complications with Functional Endoscopic Sinus Surgery performed during last 10 years in our ENT department. We analyzed endocranial complications, their causes, consequences, treatments and outcomes. Management was performed in collaboration with neurosurgeons and infectious diseases specialists. Results: Of 763 Functional Endoscopic Sinus Surgery procedures, we identified three cases with endocranial complications (0.393%). These complications included: a case of postoperative severe cerebrospinal fluid leak in a patient treated for severe polyposis;a case of cerebral-frontal abscess with delayed clinical manifestation (4 weeks post-surgery) in a patient treated for chronic pansinusitis who experienced difficult surgery for septal spur;and a case of pneumocephalus in a patient treated for allergic fungal sinusitis. The clinical outcome was favorable in all cases. Conclusions: Intra-operative cerebrospinal fluid leak, anatomical deformities (even minimal deformities) and massive inflammatory sinus disease are predisposing factors for endocranial complications with Functional Endoscopic Sinus Surgery. Prognosis can be favorable when therapeutic management is carried out in collaboration with neurosurgeons and infectious disease specialists.

关键词： Cerebral Abscess Cerebrospinal Fluid Leak Inflammatory Sinus Disease Pneumocephalus Polyposis

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Acquired Hemophilia A Simulating Retropharyngeal Abscess: Importance of Differential Diagnosis of Neck Masses before Surgery

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International Journal of Otolaryngology and Head & Neck Surgery 2015年第4期4卷 282-285页

作者： Isabel López-Sánchez José-Ramón Alba-García Cristina Vázquez-Romero miguel armengot-carceller ENT Department General and University Hospital Valencia Spain Rhinology Unit ENT Department General and University Hospital.Valencia University Valencia Spain

The coexistence of acquired hemophilia A with a secondary retropharyngeal hematoma is an extremely unusual condition with important clinical implications. The purpose of this paper is to present a case involving a patient whose first clinical manifestation, namely dysphagia, along with specific clinical examination and imaging findings, led to an incorrect initial diagnosis of a retropharyngeal abscess. However, performance of a more thorough clinical examination led to the correct diagnosis of a hematoma secondary to acquired hemophilia A. This allowed surgery to be avoided in a patient at a high risk of bleeding. Conclusions: Acute neck masses require meticulous differential diagnosis assessing the possible presence of various causative systemic diseases before the most appropriate therapy can be determined.

关键词： Dysphagia Cervical Inflammation Coagulopathy Hematoma APTT Parapharyngeal Spaces

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Homogeneous Microscopic Abnormalities in Sperm Morphology and Immotility as A Cause of Male Infertility

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Journal of Reproduction and Contraception 2014年第2期25卷 102-118页

作者： Delia Acevedo León Josep Ventura Gayete Carmen Aguado Mu?oz Carmen Carda Batalla miguel armengot carceller Jerónimo Forteza Vila Department of Biochemistry Clinical Analysis Universitary Hospital Dr. Peset 46017 Valencia Spain Cytology Unit Prince Felipe Research Centre (CIPF) Pathology Medical School University of Valencia General and Universitary Hospital Rhinology Unit ENT Department Surgery Department University of Valencia Valencian Institute of Pathology (IVP) Catholic University of Valencia San Vicente Mártir 46003 ValenciaSpain

Objective To study the identification of the cause of specific sperm abnormatities. Methods Two adult men with specific alterations in sperm morphology causing 100% immobility were included in this study. The study of sperm used： transmission electron microscopy （both patients）; apoptotic markers, DNA fragmentation test and fluorescence in-situ hybridization （patient 1） and immunoeytochemistry study of sperm flagellum using anti-β tubulin antibodies and ciliary activity test （patient 2）.Results Increased DNA fragmentation （52.6%） and apoptosis biomarkers were detected in patient 1, and loss of the central pair of mierotubules in patient 2 （‘9＋0＇ axoneme）; the nasal ciliary activity was normal. Conclusion Results suggest an apoptotic origin of the abnormalities in the sperm from patient 1 and dysplasia of the fibrous sheath in patient 2.

关键词： apoptotic changes dysplasia of fibrous sheath midpiece thickening necrospermia sperm immotility

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Enzymatic and chemo-enzymatic strategies to produce highly valuable chiral amines from biomass with ω-transaminases on 2D zeolites

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National Science Review 2022年第9期9卷 10-18页

作者： J.miguel carceller Karen S.Arias Maria J.Climent Sara Iborra Avelino Corma Instituto de Tecnologia Química (UPV-CSIC) Universitat Politècnica de València

Amino transaminases(ATAs) have been supported on a 2D ITQ-2 zeolite through electrostatic interactions, resulting in a highly stable active biocatalyst to obtain a variety of valuable chiral amines starting from prochiral ketones derived from biomass. We have extended the biocatalyst applications by designing a chemo-enzymatic process that allows, as the first step, prochiral ketones to be obtained from biomass-derived compounds through an aldol condensation–reduction step using a bifunctional metal/base catalyst. The prochiral ketone is subsequently converted into the chiral amine using the immobilized ATA. We show that it is feasible to couple both steps in a semi-continuous process to produce industrially relevant chiral amines with yields of >95% and ～100% enantiomer excess.

关键词： amino transaminase ITQ-2 zeolite chemo-enzymatic process biomass semi-continuous process Pd/MgO

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Japanese candlestick charts for diabetes

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World Journal of Methodology 2024年第2期14卷 167-171页

作者： Diana Boj-carceller Department of Endocrinology and Nutrition Miguel Servet University HospitalZaragoza 50009Spain

Continuous glucose monitoring(CGM)is a popular technology among the diabetic population,especially in patients with type 1 diabetes and those with type 2 diabetes treated with *** American Diabetes Association recommends standardization of CGM reports with visual cues,such as the ambulatory glucose ***,interpreting this report requires training and time for CGM to be *** this work it has been proposed to incorporate Japanese candlestick charts in glucose *** graphs are used in price analysis in financial markets and are easier to *** candle provides extra information to make prudent decisions since it reports the opening,maximum,minimum and closing glucose levels of the chosen time frame,usually the daily *** Japanese candlestick chart is an interesting tool to be considered in glucose *** graphic representation allows identification of glucose trends easily through the colors of the candles and maximum and minimum glucose values.

关键词： Japanese candlestick chart Candlestick chart Ambulatory glucose profile Glucose monitoring Continuous glucose monitoring Hypoglycemia

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Are proton pump inhibitors a new antidiabetic drug? A cross sectional study

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World Journal of Diabetes 2011年第12期2卷 217-220页

作者： Diana Boj-carceller Pilar Bocos-Terraz miguel Moreno-Vernis Alejandro Sanz-Paris Pablo Trincado-Aznar Ramón Albero-Gamboa Endocrinology and Nutrition Unit Hospital Miguel Servet Hormonal Unit Hospital Miguel Servet Clinical Documentation and Archives Unit Hospital Miguel Servet

AIM: To investigate the effect of proton pump inhibitors (PPIs) on glycemic control (HbA1c) in type 2 diabetic patients. METHODS: A crosssectional study of consecutive in-patients admitted to hospital in any department during the fi rst semester of the year 2010 who had a recent HbA1c measurement. The study excluded those with a diagnosis of hyperglycemic decompensation, diabetic onset or pregnancy. It compared HbA1c levels of those taking PPIs and those not. RESULTS: A total of 97 patients were recruited. The average HbA1C level was 7.0% ± 1.2%. Overall PPI consumption was 55.7%. HbA1c was signif icantly lower in individuals who took PPIs: -0.6%, 95% CI: -0.12 to-0.83. People who used PPIs with some type of insulin therapy had a HbA1c reduction by -0.8%, 95% CI: -0.12 to -1.48. For the rest of subgroup analysis based on the antidiabetic drug used, PPI consumption always exhibited lower HbA1c levels. CONCLUSION: PPIs seems to be consistently associated with better glycemic control in type 2 diabetes. HbA1c reduction observed is similar to incretin-based therapies.

关键词： Proton pump inhibitors Diabetes mellitus Drug therapy Hypoglycemic agents Incretins

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