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Acceptance of living liver donation among medical students: A multicenter stratified study from Spain

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World Journal of Gastroenterology 2016年第25期22卷 5800-5813页

作者： Antonio Ríos Ana Isabel López-Navas Ana Isabel López-López Francisco Javier Gómez Jorge Iriarte Rafael Herruzo Gerardo Blanco Francisco Javier Llorca Angel Asunsolo Pilar Sánchez-Gallegos Pedro Ramón Gutiérrez Ana Fernández María Teresa de Jesús Laura Martínez-Alarcón Alberto Lana Lorena Fuentes Juan Ramón Hernández Julio Virseda José Yelamos José Antonio Bondía Antonio Miguel Hernández Marco Antonio Ayala Pablo Ramírez Pascual Parrilla International Collaborative Donor Project ('Proyecto Colaborativo Internacional Donante' 30007 Casillas Murcia Spain department of Surgery Paediatrics Obstetrics and Gynaecology University of Murcia Avenida de las Fuerzas Armadas 30800 Espinardo Murcia Spain Transplant Unit Surgery Service IMIB - Virgen de la Arrixaca University Hospital Carretera Madrid-Cartagena s/n 30120 El Palmar Murcia Spain Regional Transplant Centre Consejeria de Sanidad y Consumo de la Region de Murcia 30008 Ronda de Levante Murcia Spain Hospital Clinico Universitario Virgen de la Arrixaca Departamento de Cirugia General y del Aparato Digestivo Unidad de Trasplantes 30007 Casillas Murcia Spain department of Psychology Universidad Catolica San Antonio (UCAM) Avenida de los Jeronimos 30107 Guadalupe Murcia Spain department of Urology San Juan University Hospital of Alicante 03010 Calle Pintor Baeza Alicante Spain Universidad de Granada Avenida del Hospicio s/n 18010 Granada Spain Universidad de Navarra Campus Universitario 31080 Pamplona Navarra Spain Universidad Autonoma de Madrid Ciudad Universitaria de cantoblanco 28049 Madrid Spain servicio de Cirugia HBP y Trasplante Hepatico Complejo Hospitalario Universitario de Badajoz Hospital Infanta Cristina Avenida Elvas s/n 06006 Badajoz Spain Universidad de Cantabria Avenida los Castros s/n 39005 Santander Cantabria Spain departamento de Cirugia Ciencias Medicas y Sociales Facultad de Medicina y Ciencias de la Salud Universidad de Alcala Campus Cientifico-Tecnologico Plaza de San Diego s/n 28801 Alcala de Henares Madrid Spain Facultad de Medicina Universidad de Malaga 29071 Avenida de Cervantes Malaga Spain servicio de Urologia (Complejo Hospitalario Universitario de Canarias CHUC) y Departamento de Cirugia (Universidad de La Laguna ULL) Calle Molinos de Agua s/n 38207 San Cristobal de La Laguna Santa Cruz de Tenerife Spain departamento de Ciencias Biomedicas Basicas Facultad de Ciencias Biomedicas Universidad Europea de

AIM: To analyze the attitude of Spanish medical students toward living liver donation (LLD) and to establish which factors have an influence on this ***: Study type: A sociological, interdisciplinary, multicenter and observational study. Study population: Medical students enrolled in Spain (n = 34000) in the university academic year 2010-2011. Sample size: A sample of 9598 students stratified by geographical area and academic year. Instrument used to measure attitude: A validated questionnaire (PCID-DVH RIOS) was self-administered and completed anonymously. Data collection procedure: Randomly selected medical schools. The questionnaire was applied to each academic year at compulsory sessions. Statistical analysis: Student´s t test, χ2 test and logistic regression ***: The completion rate was 95.7% (n = 9275). 89% (n = 8258) were in favor of related LLD, and 32% (n = 2937) supported unrelated LLD. The following variables were associated with having a more favorable attitude: (1) age (P = 0.008); (2) sex (P demic year (P de toward deceased donation (P de toward living kidney donation (P ded (P dents have a favorable attitude toward LLD.

关键词： Attitude Living liver donation Medical students Transplantation Organ donation Psychosocial variables Spain

Risk of gastrointestinal cancer in a symptomatic cohort after a complete colonoscopy:Role of faecal immunochemical test

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World Journal of Gastroenterology 2020年第1期26卷 70-85页

作者： Noel Pin-Vieito María J Iglesias David Remedios Lorena Rodríguez-Alonso Francisco Rodriguez-Moranta VictoriaÁlvarez-Sánchez Fernando Fernández-Bañares Jaume Boadas Eva Martínez-Bauer Rafael Campo Luis Bujanda Ángel Ferrandez Virginia Piñol Daniel Rodríguez-Alcalde Jordi Guardiola Joaquín Cubiella Gastroenterology department Complexo Hospitalario Universitario de OurenseCentro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas(CIBERehd)Ourense 32005Spain department of Gastroenterology and Hepatology University Hospital of Bellvitge-IDIBELLL'Hospitalet de LlobregatBarcelona 08907Spain.Ciber de Epidemiología y Salud Pública(CIBERESP)Spain Gastroenterology department Complejo Hospitalario de PontevedraPontevedra 36001Spain Gastroenterology department Hospital Universitari Mútua de TerrassaCIBERehdTerrassa 08221Spain Gastroenterology department Consorci Sanitari de TerrassaTerrassa 08221Spain Gastroenterology department Hospital de SabadellCorporacióSanitària Donostia Hospital Biodonostia InstituteUniversity of the Basque Country UPV/EHUCIBERehdSan Sebastian 20010Spain servicio de Aparato digestivo Hospital Clínico UniversitarioIIS AragónUniversity of ZaragozaCIBERehdZaragoza 50009Spain Gastroenterology department Hospital Dr.Josep TruetaGirona 17007Spain Digestive Disease Section Hospital Universitario de MóstolesMadrid 28935Spain

BACKGROUND Faecal immunochemical test(FIT)has been recommended to assess symptomatic patients for colorectal cancer(CRC)***,some conditions could theoretically favour blood originating in proximal areas of the gastrointestinal tract passing through the colon unmetabolized.A positive FIT result could be related to other gastrointestinal cancers(GIC).AIM To assess the risk of GIC detection and related death in FIT-positive symptomatic patients(threshold 10μg Hb/g faeces)without *** Post hoc cohort analysis performed within two prospective diagnostic test studies evaluating the diagnostic accuracy of different FIT analytical systems for CRC and significant colonic lesion *** patients with gastrointestinal symptoms referred consecutively for colonoscopy from primary and secondary healthcare,underwent a quantitative FIT before undergoing a complete *** without CRC were divided into two groups(positive and negative FIT)using the threshold of 10μg Hb/g of faeces and data from follow-up were retrieved from electronic medical records of the public hospitals involved in the *** determined the cumulative risk of GIC,CRC and upper *** rate(HR)was calculated adjusted by age,sex and presence of significant colonic *** We included 2709 patients without CRC and a complete baseline colonoscopy,730(26.9%)with FIT≥10μgr Hb/*** a mean time of 45.5±20.0 mo,a GIC was detected in 57(2.1%)patients:An upper GIC in 35(1.3%)and a CRC in 14(0.5%).Thirty-six patients(1.3%)died due to GIC:22(0.8%)due to an upper GIC and 9(0.3%)due to ***-positive subjects showed a higher CRC risk(HR 3.8,95%CI:1.2-11.9)with no differences in GIC(HR 1.5,95%CI:0.8-2.7)or upper GIC risk(HR 1.0,95%CI:0.5-2.2).Patients with a positive FIT had only an increased risk of CRC-related death(HR 10.8,95%CI:2.1-57.1)and GIC-related death(HR 2.2,95%CI:1.1-4.3),with no differences in upper GIC-related death(HR 1.4,95%CI:0.6-3.3).An

关键词： Colonoscopy Colorectal cancer Faecal immunochemical test Gastric cancer Gastroesophageal cancer Gastrointestinal cancer Symptoms

Cardiovascular assessment in liver transplant for nonalcoholic steatohepatitis patients:What we do,what we should do

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World Journal of Hepatology 2017年第15期9卷 697-703页

作者： Yolanda Sanchez-Torrijos Javier Ampuero Manuel Romero-Gómez Unidad Intercentros de Aparato digestivo Hospitales Universitarios Virgen del Rocio-Virgen Macarena Instituto de Biomedicina de Sevilla Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas(CIBERehd)

Non-alcoholic fatty liver disease(NAFLD) is increasing considerably due to the current lifestyle,which means that it is becoming one of the main indications for liver *** the other hand,there is a strong association between NAFLD and cardiovascular *** has been evidenced in many studies revealing a higher presence of carotid plaques or carotid intima-media thickness,leading to cardiovascular events and,ultimately,*** to the liver transplant guidelines,screening for heart disease in transplant candidates should be performed by electrocardiogram and transthoracic echocardiography while a stress echocardiogram should be reserved for those with more than two cardiovascular risk factors or greater than 50 years ***,there are no specific recommendations in NAFLD patients requiring a liver transplantation,despite its well-known cardiovascular risk *** studies have shown that these patients probably require a more exhaustive assessment and a global approach including other specialists such as cardiologists or ***,the incidence of cardiovascular disease is also increased in NAFLD patients in the post-transplantation period in comparison with other etiologies,because of the pre-existent risk factors together with the immunosuppressive ***,an early intervention on the lifestyle and the individualized selection of the immunosuppressive regimen could lead to a modification of the cardiovascular risk factors in NAFLD patients requiring a liver transplantation.

关键词： Cardiovascular risk Non-alcoholic fatty liver disease Non-alcoholic steatohepatitis Pre-transplant assessment Liver transplantation

胃食管反流症状的医疗咨询:原因及其相关因素

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世界核心医学期刊文摘（胃肠病学分册） 2005年第6期1卷 14-15页

作者： Rey E. Moreno-Elola-Olaso C. Rodriguez-Artalejo F. Diaz-Rubio M. 徐小洁 servicio de Aparato digestivo Hospital Clnico San Carlos c/ Martn Lagos s/n ES-28040 Madrid Spain Dr.

Objectives: To evaluate the frequency of medical consultation for gastro-oesophageal reflux symptoms (GORS) and to ascertain reasons for consultation and associated factors. Methods: Telephone survey of 2,500 persons using a validated questionnaire. Data were analyzed using multiple logistic regression, in which the dependent variable was consultation for GORS and the independent variables were sociodemographic factors and the clinical characteristics of GORS. Results: Of those reporting GORS, 28%had consulted their physician about them in the last year. Main reasons for seeking medical advice were GORS-induced concern in 48%, and intensity of GORS in 42.6%. Factors independently associated with medical consultation were: housewife (odds ratio (OR) 1.9; 95%CI 1.1-3.4) or retired status (OR 2.3; 95%CI 1.3-4.1), frequent GORS (OR 2.4; 95%CI 1.6-3.5), severe GORS (OR 2.4; 95%CI 1.4-4.2), nocturnal GORS (OR 1.6; 95%CI 1.1-2.3), and association of epigastric pain (OR 1.7; 95%CI 1.0-2.7) or nausea (OR 1.7; 95%CI 1.1-2.8). Conclusion: The high frequency of medical consultation for GORS in Spain makes it an important healthcare problem. The fact that half the patients seek medical advice due to concern about the nature of GORS illustrates the benefits of explaining the nature, treatment and prognosis of GORS. The clinical relevance of GORS does not reside in its frequency alone, since severe or nocturnal symptoms, albeit occasional, are also associated with medical consultation.

关键词：胃食管反流内科医生医疗问题临床相关性电话调查人口统计

Digestive and breast cancer patients managed during the first wave of COVID-19 pandemic:Short and middle term outcomes

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World Journal of Methodology 2024年第2期14卷 107-126页

作者： Jacobo Trébol Ana Carabias-Orgaz María Carmen Esteban-Velasco Asunción García-Plaza Juan Ignacio González-Munoz Ana Belén Sánchez-Casado Felipe Carlos Parreno-Manchado Marta Eguía-Larrea José Antonio Alcázar-Montero Cirugía General y del Aparato digestivo Complejo Asistencial Universitario de SalamancaSalamanca 37007SalamancaSpain Cirugía Universidad de SalamancaSalamanca 37007SalamancaSpain Oftalmología Complejo Asistencial Universitario de SalamancaSalamanca 37007SalamancaSpain

BACKGROUND The first wave of coronavirus disease 2019(COVID-19)pandemic in Spain lasted from middle March to the end of June *** population was subjected to lockdown periods and scheduled surgeries were discontinued or reduced during variable *** our centre,we managed patients previously and newly diagnosed with *** established a strategy based on limiting perioperative social contacts,preoperative screening(symptoms and reverse transcriptionpolymerase chain reaction)and creating separated in-hospital COVID-19-free pathways for non-infected *** also adopted some practice modifications(surgery in different facilities,changes in staff and guidelines,using continuously changing personal protective equipment…),that supposed new *** To analyse cancer patients with a decision for surgery managed during the first wave,focalizing on outcomes and pandemic-related *** We prospectively included adults with a confirmed diagnosis of colorectal,oesophago-gastric,liver-pancreatic or breast cancer with a decision for surgery,regardless of whether they ultimately underwent *** analysed short-term outcomes[30-d postoperative morbimortality and severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)infection]and outcomes after 3 years(adjuvant therapies,oncological events,death,SARS-CoV-2 infection and vaccination).We also investigated modifications to usual *** From 96 included patients,seven didn’t receive treatment that period and four never(3 due to COVID-19).Operated patients:28 colon and 21 rectal cancers;laparoscopy 53.6%/90.0%,mortality 3.57%/0%,major complications 7.04%/25.00%,anastomotic leaks 0%/5.00%,3-years disease-free survival(DFS)82.14%/52.4%and overall survival(OS)78.57%/76.2%.Six liver metastases and six pancreatic cancers:no mortality,one major complication,three grade A/B liver failures,one bile leak;3-year DFS 0%/33.3%and OS 50.0%/33.3%(liver metastases/pancreatic carcinoma).5 g

关键词： COVID-19 SARS-CoV-2 Colon cancer Rectal cancer Breast cancer Liver cancer Pancreatic cancer Gastric cancer Oesophageal cancer Surgery

Role of bacterial and genetic factors in gastric cancer in Costa Rica

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World Journal of Gastroenterology 2009年第2期15卷 211-218页

作者： Sergio A Con Hiroaki Takeuchi Gil R Con-Chin Vicky G Con-Chin Nobufumi Yasuda Reinaldo Con-Wong Centro digestivo Doctores Con-Mediplaza Pavas 245-1200 San José Costa Rica department of Clinical Laboratory Medicine Kochi Medical School Kochi University Nankoku-city Kochi 783-8505 Japan department of Public Health Kochi Medical School Kochi University Nankoku-city Kochi 783-8505 Japan

AIM： To evaluate several risk factors for gastric cancer （GC） in Costa Rican regions with contrasting GC incidence rate （GCIR）. METHODS： According to GCIR, 191 Helicobacter pylori （H pylori）-positive patients were classified into groups A （high GCIR, n = 101） and B （low GCIR, n = 90）. Human DNA obtained from biopsy specimens was used in the determination of polymorphisms of the genes coding for interleukin （IL）-1β and IL-10 by PCRRFLP, and IL-1RN by PCR. H pylori DNA extractions obtained from clinical isolates of 83 patients were used for PCR-based genotyping of H pylori cagA, vacA and babA2. Human DNA from gastric biopsies of 52 GC patients was utilized for comparative purposes. RESULTS： Cytokine polymorphisms showed no association with GCIR variability. However, gastric atrophy, intestinal metaplasia and strains with different vacA genotypes in the same stomach （mixed strain infection） were more frequently found in group A than in group B, and cagA and vacA s1b were significantly associated with high GCIR （P = 0.026 and 0.041, respectively）. IL- 1β＋3954_T/C （OR 2.1, 1.0-4.3）, IL-1RN^＊2/L （OR 3.5, 1.7-7.3） and IL-10-592_C/A （OR 3.2, 1.5-6.8） were individually associated with GC, and a combination of these cytokine polymorphisms with Hpylori vacA slb and ml further increased the risk （OR 7.2, 1.4-36.4）. CONCLUSION： Although a proinflammatory cytokine genetic profile showed an increased risk for developing GC, the characteristics of Hpylori infection, in particular the status of cagA and vacA genotype distribution seemed to play a major role in GCIR variability in Costa Rica.

关键词： Costa Rica Gastric cancer Helicobacterpylori Host genetic factors

从急性胰腺炎患者血清中检测并鉴别细菌DNA

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世界核心医学期刊文摘（胃肠病学分册） 2006年第1期2卷 38-39页

作者： de Madaria E. Martnez J. Lozano B. M. Pé rez-Mateo 李翔 Secció n Aparato digestivo Hospital General Universitario de Alicante Pintor Baeza s/n 03010Alicante Spain Dr.

Background and aims: Bacterial infections are common complications in patients with acute pancreatitis, and translocation of bacteria from the intestinal lumen is probably the first step in the pathogenesis of these infections. As blood cultures in afebrile patients are usually negative, more sensitive methods to investigate this hypothesis in patients are needed. Our group has recently developed a method to detect the presence of bacterial DNA in biological fluids, and we aimed to detect bacterial DNA in patients with acute pancreatitis, as molecular evidences of bacterial translocation. Methods: Samples of blood were obtained on three consecutive days within the first six days after admission. Bacterial DNA was detected using a polymerase chain reaction based method, and an automated DNA nucleotide sequencing process allowed identification of bacteria species. Results: Thirty one consecutively admitted patients with acute pancreatitis were studied. Bacterial DNA was detected in six patients (19.3% ), and the sequencing process allowed identification of Citrobacter freundii and Pseudomonas aeruginosa. In two patients the same bacteria detected at admission was detected 24 hours later (above 99.9% homology of nucleotide sequence). Basic clinical and biochemical characteristics were similar among patients with or without the presence of bacterial DNA. Conclusion: detection of gram negative bacteria derived bacterial DNA in our series supports the contention that bacterial translocation is a systemic process in approximately 20% of patients with acute pancreatitis that does not seem to be related to the severity of the episode or immediate development of

关键词： DNA 聚合酶链反应同源性血标本系统化过程分子生物学特征弗氏柠檬酸杆菌疾病发作序列分

Role of chemokines and their receptors in viral persistence and liver damage during chronic hepatitis C virus infection

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World Journal of Gastroenterology 2008年第47期14卷 7149-7159页

作者： Juan R Larrubia Selma Benito-Martínez Miryam Calvino Eduardo Sanz-de-Villalobos Trinidad Parra-Cid department of Gastroenterology Guadalajara University HospitalUniversity of AlcaláDonante de Sangre st.19002 GuadalajaraSpain Guadalajara University Hospital University of AlcaláDonante de Sangre st.19002 GuadalajaraSpain

Chemokines produced in the liver during hepatitis C virus(HCV) infection induce migration of activated T cells from the periphery to infected *** milieu of chemokines secreted by infected hepatocytes is predominantly associated with the T-helper cell/Tc1 T cell(Th1/Tc1) *** chemokines consist of CCL3(macrophage inflammatory protein-1α;MIP-1α),CCL4(MIP-1β),CCL5(regulated on activation normal T cell expressed and secreted;RANTES),CXCL10(interferon-γ-inducible protein-10;IP-10),CXCL11(interferon-inducible T-cell α chemoattractant;I-TAC),and CXCL9(monokine induced by interferon γ;Mig) and they recruit T cells expressing either CCR5 or CXCR3 chemokine *** and peripheral blood levels of these chemokines are increased during chronic hepatitis *** interaction between chemokines and their receptors is essential in recruiting HCV-specific T cells to control the *** the adaptive immune response fails in this task,non-specific T cells without the capacity to control the infection are also recruited to the liver,and these are ultimately responsible for the persistent hepatic *** modulation of chemokine receptor expression and chemokine secretion could be a viral escape mechanism to avoid specific T cell migration to the liver during the early phase of infection,and to maintain liver viability during the chronic phase,by impairing non-specific T cell *** chemokines and their receptors correlate with liver damage,and CXCL10(IP-10) and CXCR3 levels have shown a clinical utility as predictors of treatment response *** regulation of chemokines and their receptors could be a future potential therapeutic target to decrease liver inflammation and to increase specific T cell migration to the infected liver.

关键词： Chemokines Chemokine receptors Hepatitis C virus Viral hepatitis pathogenesis Persistentinfection Viral escape mechanism

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试纸法在快速诊断自发性脓胸中的应用

世界核心医学期刊文摘（胃肠病学分册） 2005年第9期1卷 52-52页

作者： Castellote J. Lopez C. Gornals J. 徐瑞 servicio de Aparato digestivo Hospital Universitari de Bellvitge C/Feixa Llarga s/n 08907 L'Hospitalet de Llobregat Barcelona Spain Dr.

Goals: To assess the utility of reagent strips for rapid diagnosis of spontaneous bacterial empyema in cirrhotic patients with hepatic hydrothorax. Background: Analysis of ascitic fluid using reagent strips is a useful diagnostic test for spontaneous bacterial peritonitis. Methods: A reagent strip for leukocyte esterase designed for the testing of urine was used to evaluate pleural fluid analysis in 47 nonselected thoracenteses in 28 cirrhotic patients with hepatic hydrothorax. Results: Twelve spontaneous bacterial empyemas were diagnosed. Simultaneous spontaneous bacterial peritonitis was present in 7 of 10 cases in which ascites fluid was analyzed. When a test result of 3 or 4 was considered positive, sensitivity was 83%(10 of 12), specificity was 100%(35 of 35), and positive predictive value was 100%. When result of 2 or more was considered positive, sensitivity was 92%(11 of 12), specificity was 80%(28 of 35), and negative predictive value was 97%. Conclusion: Analysis of pleural fluid with reagent strips is a rapid, easy to use, and inexpensive tool for the diagnosis of spontaneous bacterial empyema in cirrhotic patients. A positive result should be considered an indication for antibiotic therapy.

关键词：试纸法胸腔穿刺硬化肝特异性预测价值白细胞酯酶阳性预测值诊断方法分析检验