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Relationship between lipoprotein （a） and micro/macro complications in type 2 diabetes mellitus： a forgotten target

Journal of Geriatric Cardiology 2015年第2期12卷 93-99页

作者： rocio Toro Eduardo Segura Jesfis Millan Nunez-Cortes Juan Carlos Pedro-Botet Maribel Quezada-Feijoo Alipio Mangas Department of Medicine Cfdiz University School of Medicine Cdtdiz 11002 C/ Dr Marahon S/N Cadiz Spain Department of Internal Medicine University Hospital Puerta del Mar Cadiz 11002 Ana de Viya S/N Cadiz Spain Department of Internal Medicine University Hospital Gregorio Maranon Madrid28007 C/Doctor Esquerdo 46 Madrid Spain Department of Internal Medicine University Hospital del Mar Barcelona 08003 Passeig Marltim 25-29 Barcelona Spain Department of Cardiology Cruz Roja Hospital Madrid 28003 Av. de la Reina Victoria 22-26 Madrid Spain

Objectives Increased lipoprotein （a） serum concentration seems to be a cardiovascular risk factor; this has not been confirmed in extracoronary atherosclerosis complications. We therefore wished to gain a deeper insight into relationship between the plasma concentrations of lipoprotein （a） and the micro- and macro-vascular complications of type 2 diabetes mellitus and to identify possible differences in this association. Methods This is a descriptive observational cross-sectional study. Two-hundred and seventeen elderly patients with type 2 diabetes mellitus were included from the internal medicine outclinic. Anthropometric data, analytical data （insulin reserve, basal and postprandial peptide C, glycosylated hemoglobin, renal parameters, lipid profile and clinical data as hypertension, obesity, micro and macrovascular complications were collected. Results Patients were grouped according to the type 2 diabetes mellitus time of evolution. The mean plasma concentration of lipoprotein （a） was 22.2± 17.3 mg/dL （22.1± 15.9 mg/dL for males, and 22.1 ± 18.4 mg/dL for females）. Patients with hypertension, coronary heart disease, cerebrovascular accident, microalbuminuria and proteinuria presented a statistically significant increased level of lipoprotein （a）. Similarly, the patients with hyperlipoprotein （a）（≥30 mg/dL） presented significantly increased levels of urea and total cholesterol. In the multivariate regression model, the level of lipoprotein （a） is positively correlated with coronary heart disease and diabetic nephropathy （P 〈 0.01 and P 〈 0.005, respectively）. Conclusions The elevation of plasma levels of lipoprotein （a） are associ- ated with the development of coronary heart disease and diabe tic nephropathy. Therefore, we consider that the determination of lipoprotein （a） may be a prognostic marker of vascular complications in patients with type 2 diabetes mellitus.

关键词： Lipoprotein (a) Macrovascular complications Type 2 diabetes Risk factors

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Alpha-1 antitrypsin deficiency and the risk of hepatocellular carcinoma in end-stage liver disease

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World Journal of Hepatology 2015年第10期7卷 1427-1432页

作者： Clara Antoury rocio Lopez Nizar Zein James K Stoller Naim Alkhouri Department of Internal Medicine Cleveland Clinic Foundation Department of Quantitative Health Sciences Cleveland Clinic Foundation Department of Gastroenterology and Hepatology and Digestive Disease Institute Cleveland Clinic Foundation Departments of Pulmonary and Critical Care Respiratory Institute and Education InstituteCleveland Clinic Foundation

AIM:To evaluate the association between alpha-1 antitrypsin deficiency(A1ATD) and hepatocellular carcinoma(HCC) in patients with end-stage liver disease(ESLD).METHODS:Patients with cirrhosis and ESLD referred to the Cleveland Clinic Foundation for liver transplantation between 2003 and 2014 were included in the study(N = 675). ESLD was defined as having histological features of cirrhosis and/or radiological evidence of cirrhosis in the context of portal hypertension(ascites,variceal bleeding,thrombocytopenia,or hepatic encephalopathy). A1 ATD was diagnosed using phenotype characterization(MZ or ZZ),liver biopsy detection of PAS-positive diastaseresistant(PAS+) globules,or both. Patients with other causes of liver diseases such as hepatitis C virus(HCV),alcoholic liver disease and non-alcoholic steatohepatitis(NASH) or NASH were also included in the study. HCC was diagnosed by using imaging modalities,biopsy findings,or explanted liver inspection. Follow-up time was defined as the number of years from the diagnosis of cirrhosis to the diagnosis of hepatocellular carcinoma,or from the diagnosis of cirrhosis to the last follow up visit. The rate of HCC was assessed using time-tointerval analysis for interval censored ***:This study included 675 patients. 7% of subjects had A1ATD(n = 47). Out of all subjects who did not have A1 ATD,46% had HCV,17% had alcoholic liver disease,19% had NASH and 18% had another primary diagnosis. Of the 47 subjects with A1 ATD,15 had a primary diagnosis of A1ATD(PI*ZZ phenotype and PAS+ globules),8 had a PI*MZ phenotype alone,14 had PAS+ alone,and 10 had both the PI*MZ phenotype and PAS+. Median follow-up time was 3.4(25th,75 th percentiles:1,5.2) years. The overall rate of hepatocellular carcinoma in all subjects was 29%(n = 199). In the A1 ATD group,the incidence rate of HCC was 8.5% compared to 31% in the group of patients with other causes of cirrhosis(P = 0.001). Patients with ESLD due to A1 ATD had the lowest yearly cumulativ

关键词： Hepatocellular carcinoma Liver cirrhosis End-stage liver disease Hepatitis C virus Alpha-1antitrypsin deficiency

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Recurrence and survival rates of inflammatory bowel disease-associated colorectal cancer following postoperative chemotherapy:a comparative study

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Gastroenterology Report 2017年第1期5卷 57-61,I0002,I0003页

作者： Mohannad Dugum Jingmei Lin rocio Lopez Bassam Estfan Elena Manilich Luca Stocchi Bo Shen Xiuli Liu Division of Gastroenterology Hepatology and NutritionDepartment of MedicineUniversity of PittsburghPittsburghPAUSA Department of Pathology and Laboratory Medicine Indiana University School of MedicineIndianapolisINUSA Quantitative Health Sciences Cleveland ClinicClevelandOHUSA Department of Hematology and Oncology Taussig Cancer InstituteCleveland ClinicClevelandOHUSA Department of Colorectal Surgery Digestive Disease InstituteCleveland ClinicClevelandOHUSA Department of Gastroenterology and Hepatology Digestive Disease InstituteCleveland ClinicClevelandOHUSA Department of Anatomic Pathology Pathology&Laboratory Medicine InstituteCleveland ClinicClevelandOHUSA

Background and Aim:Inflammatory bowel disease(IBD)is associated with an increased risk of colorectal cancer(CRC).Studies have shown tumorigenetic and histomorphological differences between IBD-associated CRC and non-IBD CRC,suggesting differences in tumor behavior and response to *** aimed to compare tumor recurrence and survival rates following postoperative chemotherapy in CRC patients with and without ***:Search of the Cleveland Clinic’s CRC database revealed 65 patients who had IBD-associated CRC and received postoperative adjuvant chemotherapy between 1994 and ***-one patients were excluded due to incomplete clinical *** score-matching based on age,surgery intent,CRC site,tumor grade,American Joint Committee on Cancer(AJCC)stage and T stage was used to match IBD and non-IBD patients(1:4).Competing risk and Cox regression models were used to analyze differences in disease-free survival and overall survival,***:Forty-four patients with IBD-associated CRC were matched to 176 patients with non-IBD *** IBD patients,29(66%)had ulcerative colitis,14(32%)had Crohn’s disease,and one(2%)had indeterminate *** IBD diagnosis age was 28.1±14.5 years,and mean IBD duration at time of CRC treatment was 21.5±12.6 ***(23%)IBD patients had tumor recurrence compared with 34(19%)non-IBD patients(P=.074).There was no significant difference in disease-free survival(hazard ratio[HR]=0.60;95%CI:0.35–1.05;P=0.074)or overall survival(HR=0.87;95%CI:0.54–1.4;P=0.58)between IBD and non-IBD ***:Patients with IBD-associated CRC have comparable rates of tumor recurrence and survival following postoperative chemotherapy as CRC patients without *** studies are needed to confirm these findings and guide therapeutic decisions.

关键词： inflammatory bowel disease colorectal cancer adjuvant chemotherapy prognosis

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An Unforgettable Ping Pong Trip

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Voice of Friendship 2009年第Z1期 44-45页

作者： Melba rocio

In our memory the famous Ping Pong Diplomacy took place in 1971. At that time the People’s Republic of China and the United States had not yet es- tablished diplomatic relations. In April that year, nine table

关键词： diplomatic Republic invitation visit match friends

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What is the most effective exercise protocol to improve cardiovascular fitness in overweight and obese subjects？

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Journal of Sport and Health Science 2017年第4期6卷 454-461页

作者： Eliane Aparecida Castro Ana Belen Peinado Pedro Jose Benito MercedeS Galindo Marcela Gonzalez-Gross rocio Cupeiro Department of Health and Human Performance Faculty of Physical Activity and Sport Sciences Universidad Polit~cnica de Madrid Madrid 28040 Spain LFE Research Group Universidad PolitOcnica de Madrid Madrid 28040 Spain Faculty of Physical Activity and Sport Sciences Universidad Politecnica de Madrid Madrid 28040 Spain ImFINE Research Group Universidad PolitOcnica de Madrid Madrid 28040 Spain

Background: Increased peak oxygen consumption(VO2 peak) can reduce cardiovascular risks associated with obesity. Our aim was to analyze the effect of a weight loss program on cardiovascular fitness in overweight(W) and obese(O) ***: One hundred and sixty-seven subjects(77 males and 90 females), aged 18–50 years, performed a modified Bruce protocol before(pre)and after(post) a weight loss program of 24 weeks. This program combined physical training(strength, S; endurance, E; combined strength + endurance, SE; or physical activity recommendation, PA) 3 times per week, with a 25%–30% caloric restriction ***: VO2 peak improved in overweight and obese males(pre and post values in L/min, respectively; W = 3.2 ± 0.6 vs. 3.7 ± 0.5, p < 0.001;O = 3.6 ± 0.6 vs. 3.8 ± 0.6, p = 0.013) as well as in overweight females(2.0 ± 0.3 vs. 2.3 ± 0.4, p < 0.001). VO2 peak in the first ventilatory threshold(VT1) increased for all 4 interventions in males(p < 0.05), except for S in the obese group(1.6 ± 0.2 vs. 1.7 ± 0.3, p = 0.141). In females, it increased in E(0.9 ± 0.2 vs. 1.4 ± 0.3, p < 0.001), SE(0.9 ± 0.2 vs. 1.2 ± 0.4, p = 0.003), and PA(0.9 ± 0.1 vs. 1.2 ± 0.2, p = 0.006) in overweight groups. Time-to-exhaustion improved in all subjects except for females in PA group(15.7 ± 0.3 min vs. 15.9 ± 0.3 min, p = 0.495).Conclusion: Our results suggest that all methods, including the recommendation of physical activity, can improve cardiovascular fitness in overweight subjects and obese males.

关键词： Combined training Endurance training Obesity Oxygen consumption Physical activity Strength training Ventilatory threshold

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Medications in type-2 diabetics and their association with liver fibrosis

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World Journal of Gastroenterology 2020年第23期26卷 3249-3259页

作者： Mohamed Tausif Siddiqui Hina Amin Rajat Garg Pravallika Chadalavada Wael Al-Yaman rocio Lopez Amandeep Singh Department of Gastroenterology Hepatology and NutritionDigestive Diseases and Surgery InstituteCleveland ClinicClevelandOH 44195United States Department of Hospital Medicine Cleveland ClinicOH 44195United States Department of Quantitative Health Sciences Cleveland ClinicOH 44195United States

BACKGROUND The prevalence of nonalcoholic fatty liver disease(NAFLD) is significantly rising worldwide. Type-2 diabetes(T2D) is a major risk factor for NAFLD *** To assess the association of commonly used medications to advanced fibrosis(AF) in patients with biopsy-proven NAFLD and *** We used the International Classification of Disease 9 th Revision Clinical Modification coding system to identify patients with T2D and included patients who underwent liver biopsy for suspected NAFLD between January 1, 2000 to December 31, 2015. We compared demographics, clinical characteristics, and differences in pattern of medication use in patients who had biopsy-proven AF to those without it. A univariate and multivariate analysis was performed to assess the association of different classes of medication with the presence of *** A total of 1183 patients were included in the final analysis, out of which 32%(n =381) had AF on liver biopsy. Mean age of entire cohort was 52 years and majority were females(65%) and Caucasians(85%). Among patients with AF, 51% were on oral hypoglycemics, 30% were on insulin, 66% were on antihypertensives and 27% were on lipid lowering agents for the median duration of 19 mo, 10 mo, 26 mo, and 24 mo respectively. Medications associated with decreased risk of AF included metformin, liraglutide, lisinopril, hydrochlorothiazide, atorvastatin and simvastatin while the use of furosemide and spironolactone were associated with higher prevalence of *** In our cohort of T2D with biopsy proven NAFLD, the patients who were receiving metformin, liraglutide, lisinopril, hydrochlorothiazide, atorvastatin and simvastatin were less likely to have AF on biopsy, while patients who were receiving furosemide and spironolactone had a higher likelihood of having AF when they underwent liver biopsy. Future studies are needed to confirm these findings and to establish measures for prevention of NAFLD progression in patients with T2D.

关键词： Diabetes medications Anti-lipid medications Antihypertensive medication Fatty liver Advanced fibrosis

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Outpatient telephonic transitional care after hospital discharge improves survival in cirrhotic patients

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World Journal of Hepatology 2019年第8期11卷 646-655页

作者： Bhavana Bhagya Rao Anastasia Sobotka rocio Lopez Carlos Romero-Marrero William Carey Department of Gastroenterology Hepatology and Nutrition Cleveland Clinic

BACKGROUND Intervention to improve outcomes in cirrhotic patients (CP) after hospital discharge often focus on 30 d readmission rate (RR). However, recent studies suggest dissociation between RR and survival. At our center, CP are now offered outpatient telephonic transitional care (OTTC) by a care coordinator for 30 d after hospital discharge. AIM To determine the effect of OTTC on survival in CP. METHODS In this cohort study from a tertiary center, CP who received OTTC formed the intervention group. They were compared with a control group discharged during the same period. Mortality and RR were compared between the groups. RESULTS After OTTC introduction, 194 CP were discharged. After applying exclusion criteria, 169 CP (51% male, mean age 58 years ± 12 years) were included. OTTC group comprised 76 patients and was compared with 93 controls. Baseline disease and index admission related characteristics were not significantly different between the groups. The intervention group showed significantly higher 6 mo survival compared to controls (84.2% vs 68.8%;P = 0.03), while RR at 1, 3, and 6 mo were comparable. On multivariable analysis, the intervention group showed lower odds for mortality compared to the controls (hazard ratio: 0.4;95% confidence interval: 0.2-0.82;P = 0.012), while higher model for endstage liver disease scores were associated with higher mortality (hazard ratio: 1.05;95% confidence interval: 1.01-1.1;P = 0.024).CONCLUSION CP provided OTTC had higher 6 mo survival compared to controls without a difference in RR. Use of RR to gauge quality of care provided during hospitalization or subsequent transitional care programs should be revisited.

关键词： Quality improvement Transitional care Outpatient monitoring Outcomes assessment

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The potential of starch-chitosan blends with poloxamer for the preparation of microparticles by spray-drying

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Particuology 2024年第6期89卷 1-10页

作者： Juan Enrique Barranco-García Carolina Caicedo Enrique Javier Jiménez-Regalado Carlos Espinoza-González Graciela Morales rocio Yaneli Aguirre-Loredo Abril Fonseca-García Tecnológico Nacional de México/Instituto Tecnológico de Oaxaca Departamento de Química y BioquímicaAvenida Ing.Víctor Bravo Ahuja No.125Esquina Calzada Tecnológico68030OaxacaMexico Faculty of Engineering Unidad Central del Valle del Cauca(UCEVA)Carrera 17a 48-144763022TuluáColombia Centro de Investigación en Química Aplicada(CIQA) Blvd.Enrique Reyna Hermosillo 14025294SaltilloCoahuilaMexico Investigadoras por México CONAHCYT-CIQA Av.Insurgentes Sur 1562Col.Crédito Constructor03940Alcaldía Benito JuárezCDMXMexico

Using biopolymers as wall materials in spray drying poses challenges,particularly in attaining flowability and thermal stability among their physicochemical *** paper addresses these challenges by preparing microparticles using a blend of starch–chitosan and a poloxamer,commercially named Pluronic®*** aimed to elucidate the effects of varying poloxamer concentrations on the resulting particles through the spray drying *** with a poloxamer concentration of 3%(w/v)demonstrated a notably higher yield,especially when compared to those with 0%and 1%*** with 3%and 5%(w/v)poloxamer displayed a narrower particle size distribution,with the 3%blend showing a superior yield attributed to arrangements of blend components that improve flowability.X-ray diffraction analysis showcased the characteristic peaks of A-type starch form,with shifts suggesting enhanced interactions between *** with increased poloxamer content showed elevated thermal degradation temperatures,with the 3%blend registering a significant rise,opening avenues for encapsulating heat-sensitive *** study primarily focuses on the preparation and basic characterization of *** underscores the potential of blends with optimal poloxamer concentrations in microencapsulation,emphasizing further research to harness their capabilities thoroughly.

关键词： Biopolymer Starch Chitosan Pluronic®F127 Microparticles Spray drying

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Current status and potential of morphometric sperm analysis

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Asian Journal of Andrology 2016年第6期18卷 863-870页

作者： Alejandro Maroto-Morales Olga Garcia-Alvarez Manuel Ramon Felipe Martinez-Pastor M rocio Fernandez-Santos A Josefa Soler Jose Julian Garde SaBio IREC (CSIC - UCLM -JCCM) Albacete Spain Biomedical Center Medical Faculty in Pilsen Charles University in Prague Pilsen Czech Republic Regional Center of Animal Selection and Reproduction (CERSYRA) JCCM Valdepenas Spain 4Institute for Animal Health and Cattle Development University of Leon LeOn Spain Department of Molecular Biology University of Leon Leon Spain Faculty of Pharmacy (UCLM) Albacete Spain

The spermatozoon is the most diverse cell type known and this diversity is considered to reflect differences in sperm function. How the diversity in sperm morphology arose during speciation and what role the different specializations play in sperm function, however, remain incompletely characterized. This work reviews the hypotheses proposed to explain sperm morphological evolution, with a focus on some aspects of sperm morphometric evaluation; the ability of morphometrics to predict sperm cryoresistance and male fertility is also discussed. For this, the evaluation of patterns of change of sperm head morphometry throughout a process, instead of the study of the morphometric characteristics of the sperm head at different stages, allows a better identification of the males with different sperm cryoconservation ability. These new approaches, together with more studies employing a greater number of individuals, are needed to obtain novel results concerning the role of sperm morphometry on sperm function. Future studies should aim at understanding the causes of sperm design diversity and the mechanisms that generate them, giving increased attention to other sperm structures besides the sperm head. The implementation of scientific and technological advances could benefit the simultaneous examination of sperm phenotype and sperm function, demonstrating that sperm morphometry could be a useful tool for sperm assessment.

关键词： computer-assisted sperm morphometric analysis mammals sperm function sperm morphometry

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Pathogenesis of occult chronic hepatitis B virus infection

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World Journal of Gastroenterology 2011年第12期17卷 1543-1548页

作者： rocio Aller de la Fuente María L Gutiérrez Javier Garcia-Samaniego Conrado Fernández-Rodriguez Jose Luis Lledó Gregorio Castellano Gastroenterology Hospital Clinico Universitario Valladolid Institute of endocrinology and Nutrition Medical SchoolUniversity of Valladolid47003 ValladolidSpain Service of Gastroenterology Hospital Universitario Fundación AlcorcónAv Budapest-128922 AlcorcónMadridSpain Gastroenterology Department Hospital Carlos IIIc/Sinesio Delgado28029 MadridSpain Hospital Universitario 12 de Octubre Av de Andalucia 2804128039 MadridSpain

Occult hepatitis B infection(OBI) is characterized by hepatitis B virus(HBV) DNA in serum in the absence of hepatitis B surface antigen(HBsAg) presenting HBsAg-negative and anti-HBc positive serological *** HBV status is associated in some cases with mutant viruses undetectable by HBsAg assays;but more frequently it is due to a strong suppression of viral replication and gene *** is an entity with world-wide *** failure to detect HBsAg,despite the persistence of the viral DNA,is due in most cases to the strong suppression of viral replication and gene expression that characterizes this"occult"HBV infection;although the mechanisms responsible for suppression of HBV are not well *** majority of OBI cases are secondary to overt HBV infection and represent a residual low viremia level suppressed by a strong immune response together with histological derangements which occurred during acute or chronic HBV *** evidence suggests that it can favour the progression of liver fibrosis and the development of hepatocellular carcinoma.

关键词： Occult hepatitis B virus infection Hepatitis B virus-DNA Anti-HBc alone Hepatitis B virus Hepadnaviral hepatitis Occult viral persistence Primary occult infection Secondary occult infection Virus reactivation

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