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Assessment of skeletal muscle alterations and circulating myokines in metabolic dysfunction-associated steatotic liver disease:A crosssectional study

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World Journal of Gastroenterology 2025年第7期31卷 63-73页

作者： Yolanda Real Martinez Carlos Ernesto Fernandez-Garcia Esther Fuertes-Yebra Mario Calvo Soto Angela Berlana Vicente Barrios Maria Caldas Leticia Gonzalez Moreno Luisa Garcia-Buey Begoña Molina Baena Miguel Sampedro-Nuñez Maria J Beceiro C García-Monzón Águeda González-Rodríguez servicio Aparato Digestivo Hospital Universitario La PrincesaInstituto de Investigación Sanitaria La PrincesaUniversidad Autónoma de MadridMadrid 28006Spain unidad de Investigación Hospital Universitario Santa CristinaInstituto de Investigación Sanitaria La PrincesaMadrid 28009Spain department of Endocrinology Department of PediatricsHospital Infantil Universitario Niño JesúsInstituto de Investigación La PrincesaMadrid 28009Spain Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición Instituto de Salud Carlos IIIMadrid 28029Spain servicio de Endocrinología y Nutrición Hospital Universitario La PrincesaInstituto de Investigación Sanitaria La PrincesaUniversidad Autónoma de MadridMadrid 28006Spain Instituto de Investigaciones Biomédicas Sols-Morreale(IIBM) CSIC-UAMMadrid 28029Spain Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas Madrid 28029Spain

BACKGROUND Skeletal muscle alterations(SMAs)are being increasingly recognized in patients with metabolic dysfunctionassociated steatotic liver disease(MASLD)and appear to be associated with deleterious outcomes in these ***,their actual prevalence and pathophysiology remain to be *** To determine the prevalence of SMAs and to assess the significance of circulating myokines as biomarkers in patients with *** Skeletal muscle strength and muscle mass were measured in a cross-sectional study in a cohort of 62 patients fulfilling MASLD criteria,recruited from the outpatient clinics of a tertiary level *** degree of fibrosis and liver steatosis was studied using abdominal ultrasound and transitional *** and metabolic characteristics as well as serum levels of different myokines were also determined in the MASLD *** analysis was performed comparing results according to liver fibrosis and *** No significant differences were found in both skeletal muscle strength and skeletal muscle mass in patients with MASLD between different stages of liver ***,serum levels of fibroblast growth factor-21(FGF21)were significantly higher in patients with MASLD with advanced hepatic fibrosis(F3-F4)than in those with lower fibrosis stages(F0-F2)(197.49±198.27 pg/mL vs 95.62±83.67 pg/mL;P=0.049).In addition,patients with MASLD with severe hepatosteatosis(S3)exhibited significantly higher serum levels of irisin(1116.87±1161.86 pg/mL)than those with lower grades(S1-S2)(385.21±375.98 pg/mL;P=0.001).CONCLUSION SMAs were uncommon in the patients with MASLD *** serum levels of irisin and FGF21 were detected in patients with advanced liver steatosis and fibrosis,respectively,with potential implications as biomarkers.

关键词： Skeletal muscle alterations Myokines Metabolic dysfunction-associated steatotic liver disease Liver fibrosis Hepatosteatosis

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Timing of surgery in Crohn’s disease: A key issue in the management

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World Journal of Gastroenterology 2008年第36期14卷 5532-5539页

作者： Rafael Alós Joaquín Hinojosa servicio de Cirugía General Unidad de Coloproctología Hospital de Sagunto Valencia Spain unidad de Digestivo Servicio de Medicina Interna Hospital de Sagunto Valencia Spain

The timing of the decision for operation in Crohn’s disease is based on an evaluation of the several factors such as the failure of medical treatment, complications due to the Crohn’s disease or to the farmacological therapy, development of dysplasia or cancer and growth retardation. A complete evaluation of these factors should result in operation timed to the patient’s best advantage, achieving maximal relief of symptoms with improvement of quality of life. Given the complexity and heterogeneity of the disease and the different options for treatment, is difficult to systematize when the optimal moment for the surgery is arrived. A very important factor in the management of Crohn’s disease is the multidisciplinary approach and the patient preference should be a significant factor in determining the choice of therapy. The surgery should be considered such another option in the sequential treatment of Crohn’s disease. We have analyzed the factors that are involved in the decision taking of the surgical treatment regarding to the experience and the published literature. When did the medical therapy fail? when is the appropriate moment to operate on the patient? Or which complications of Crohn’s disease need a surgery? These are some of the questions we will try to answer.

关键词： Crohn's disease Surgical treatment Medical therapy

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Management of betablocked patients after sustained virological response in hepatitis C cirrhosis

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World Journal of Gastroenterology 2019年第21期25卷 2665-2674页

作者： Marta Abadía María Luisa Montes Dolores Ponce Consuelo Froilán Miriam Romero Joaquín Poza Teresa Hernández Rubén Fernández-Martos Antonio Olveira Antonio Olveira Servicio de Aparato DigestivoHospital Universitario La PazMadrid 28046Spain unidad VIH Servicio de Medicina InternaHospital Universitario La PazMadrid 28046Spain servicio de Radiología Hospital Universitario La PazMadrid 28046Spain CIBERehd IdiPAZ Madrid 28029Spain

BACKGROUND Current guidelines do not address the post–sustained virological response management of patients with baseline hepatitis C virus (HCV) cirrhosis and oesophageal varices taking betablockers as primary or secondary prophylaxis of variceal bleeding. We hypothesized that in some of these patients portal hypertension drops below the bleeding threshold after sustained virological response, making definitive discontinuation of the betablockers a safe option. AIM To assess the evolution of portal hypertension, associated factors, non-invasive assessment, and risk of stopping betablockers in this population. METHODS Inclusion criteria were age > 18 years, HCV cirrhosis (diagnosed by liver biopsy or transient elastography > 14 kPa), sustained virological response after directacting antivirals, and baseline oesophageal varices under stable, long-term treatment with betablockers as primary or secondary bleeding prophylaxis. Main exclusion criteria were prehepatic portal hypertension, isolated gastric varices, and concomitant liver disease. Blood tests, transient elastography, and upper gastrointestinal endoscopy were performed. Hepatic venous pressure gradient (HVPG) was measured five days after stopping betablockers. Betablockers could be stopped permanently if gradient was der treatment with propranolol or carvedilol: median age 64 years, men 54.5%, median Model for End-Stage Liver Disease (MELD) score 9, Child-Pugh score A 77%, median platelets 77.000 × 103/μL, median albumin 3.9 g/dL, median baseline transient elastography 24.8 kPa, 88% of patients received primary prophylaxis. Median time from end of antivirals to gradient was 67 wk. Venous pressure gradient was decrease from baseline. On endoscopy, variceal size regressed in 19/27 patients (70%), although gradient was

关键词： Hepatitis C virus Oesophageal varices Portal hypertension Betablocker Variceal bleeding

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Mesenchymal stem cells from different sources and their derived exosomes: A pre-clinical perspective

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World Journal of Stem Cells 2020年第2期12卷 100-109页

作者： María álvarez-Viejo unidad de Terapia Celulary Medicina Regenerativa Servicio de Hematologíay Hemoterapia Hospital Universitario Central de Asturias Plataforma de Terapias Avanzadas Instituto de Investigación Sanitaria del Principado de Asturias

Since the introduction of cell therapy as a strategy for the treatment of many diseases,mesenchymal stem cells have emerged as ideal candidates,yet the underlying mechanisms of their beneficial effects are only partially *** the start of the 21st century,a paracrine effect was proposed as a mechanism of tissue repair by these *** addition,a role was suggested for a heterogeneous population of extracellular vesicles in cell-to-cell *** of these vesicles including exosomes have been isolated from most fluids and cells,as well as from supernatants of in vitro cell *** research in the field of regenerative medicine suggests that exosomes derived from mesenchymal stem cells could be a powerful new therapeutic *** review examines the therapeutic potential of these exosomes obtained from the sources most used in cell therapy:bone marrow,adipose tissue,and umbilical cord.

关键词： Mesenchymal stem cells Exosomes Cellular therapy

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Liver histological changes and lipid peroxidation in the amphibian Ambystoma mexicanum induced by sediment elutriates from the Lake Xochimilco

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Journal of Environmental Sciences 2016年第8期28卷 156-164页

作者： Esperanza Ortiz-Ordonez Eugenia López-López Jacinto Elías Sedeno-Díaz Esther Uría Ignacio Andrés Morales María Estela Pérez Mineko Shibayama Instituto Politécnico Nacional Depto.de Formación Básica e InterdisciplinariaCICS-USTAv.de los Maestros s/n.Col.Sto Instituto Politécnico Nacional Laboratorio de Evaluación de la Salud de Ecosistemas AcuáticosENCBProl.de Carpio y Plan de Ayala s/n.Col.Sto Instituto Politécnico Nacional Coordinación Politécnica para la SustentabilidadEdificio de la Biblioteca Nacional3er PisoAv.Instituto Politécnico Nacional s/nesq.Wilfrido MassieuCol Instituto Politécnico Nacional Laboratorio de HistologíaENCBProl.de Carpio y Plan de Ayala s/n.Col.Sto unidad de servicio académico acuario BiologíaFacultad de CienciasUniversidad Autónoma de MéxicoCiudad Universitaria Laboratorio de Infectómica Centro de Investigación y de Estudios Avanzados del IPNAv.Instituto Politécnico Nacional

Lacustrine sediments accumulate pollutants that input from the lake watershed and can be released to the water column by sediment resuspension; thus, pollutants can change their bioavailability and exert adverse effects to aquatic biota. Shallow-urban lakes are particularly susceptible to receive pollutants from urban discharges and sediment resuspension. Lake Xochimilco, in Mexico City, an urban-shallow lake, faces multiple problems： urban sprawl, overexploitation of aquifers, drying of springs, discharge of wastewater from treatment plants, and sediment resuspension. The aquatic biota living in this ecosystem is continuously exposed to the release of pollutants from the sediments. We assessed the risk that pollutants released from sediments from Lake Xochimilco, Touristic（TZ） and Agriculture zone（AZ）, can exert on a native amphibian species of the lake（Ambystoma mexicanum） through exposure bioassays to sediment elutriates. We evaluate alterations in the amphibian by three approaches： biochemical（level of lipid peroxidation,LPO）, cellular（ultrastructure） and the liver histology of A. mexicanum and we compare them with a batch control. Additionally, we assessed heavy metals（Pb, Cd and Hg） in *** from TZ showed the highest concentrations of the metals assessed. Organisms exposed to sediment elutriates from either study sites showed higher LPO values than control organisms（p 〈 0.05）. Organisms exposed to elutriates from the TZ showed the most conspicuous damages： hepatic vasodilation of sinusoids, capillaries with erythrocytes,leukocyte infiltration and cytoplasmic vacuolation in hepatocytes. The biological responses assessed reflected the risk that faces A. mexicanum when is exposed for prolonged periods to sediment resuspension in Lake Xochimilco.

关键词： Elutriates Amphibian Liver Histological alterations Ultrastructure Oxidative stress Metals Urban lake

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Arrhythmogenic cardiomyopathy with left ventricular involvement versus ischemic heart disease: lessons learned from the family study and the reviewed autopsy of a young male

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Forensic Sciences Research 2019年第3期4卷 274-279页

作者： Pilar Molina Jorge Sanz-Sánchez Manuel Fenollosa Marina Martínez-Matilla Juan Giner Esther Zorio servicio de Patología Instituto de Medicina Legal y Ciencias Forenses de ValenciaValenciaEspana unidad de Valoración del Riesgo de Muerte Súbita Familiar and unidad de Cardiopatías Familiares Muerte Súbita y Mecanismos de Enfermedad(CaFaMuSMe)Instituto de Investigación Sanitaria La FeValenciaEspana servicio de Cardiología Hospital Universitario y Politécnico La FeValenciaEspana unidad Genómica Instituto de Investigación Sanitaria La FeValenciaEspana

Ischemic heart disease (IHD) is the leading cause of sudden cardiac death (SCD) and often non-thrombosed severe coronary stenoses with or without myocardial scars are *** dominant arrhythmogenic cardiomyopathy (LDAC) is a life-threating rare disease which has been more thoroughly studied in the last *** macroscopic study of an SCD victim was conducted and re-evaluated 9years *** cardiological work-up in his firstdegree relatives initially comprised an electrocardiogram (ECG) and an *** they were re-evaluted 9years later,a cardiac magnetic resonance,an ECG-monitoring,an exercise testing and a genetic study were performed and the pedigree was extended *** 2008,an IHD was suspected in the sports-triggered SCD of a 37-year-old man upon the postmortem (75% stenosis of the left main and circumflex coronary arteries;the subepicardial left ventricular fibrofatty infiltration with mild myocardial degeneration was assumed to be a past myocardial infarction).No cardiomyopathy was identified in any of the two proband's *** years thereafter,distant relatives were diagnosed with LDAC due to a pathogenic desmoplakin *** reanalysis of the two sisters showed ventricular arrhythmias in one of them without structural heart involvement and the reviewed postmortem of the proband was reclassified as LDAC based on the fibrofatty infiltration;both were mutation *** completion of the family study on 19 family members yielded one SCD due to LDAC (the proband),three living patients diagnosed with LDAC (two with a defibrillator),one mutation carrier without structural ventricular involvement,and 14 healthy relatives (who were discharged) with a very good co-segregation of the *** rare,LDAC exists and sometimes its differential diagnosis with iHD has to be *** previous postmortem misdiagnoses can help family screening to further prevent SCDs.

关键词： Forensic sciences forensic pathology ischemic heart disease arrhythmogenic cardiomyopathy family study

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Haplotype analysis of CLDN19 single nucleotide polymorphisms in Spanish patients with familial hypomagnesemia with hypercalciuria and nephrocalcinosis

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World Journal of Pediatrics 2015年第3期11卷 272-275页

作者： Ernesto Martin-Nunez Elizabeth Cordoba-Lanus Hilaria Gonzalez-Acosta Aniana Oliet Elvira Izquierdo Felix Claverie-Martin unidad de Investigacion Hospital Nuestra Senora de CandelariaSanta Cruz de TenerifeSpain servicio de Nefrologia Hospital Severo OchoaMadridSpain Nefrologia Infantil Hospital General Gregorio MaranonMadridSpain

Background:Familial hypomagnesemia with hypercalciuria and nephrocalcinosis(FHHNC)is an autosomal recessive tubular disease caused by mutations in the CLDN16 or CLDN19 *** studies using microsatellite markers flanking the CLDN19 locus estimated that p.G20D(c.59G>A),a recurrent mutation in Spanish families,is a founder *** the present study,we assessed the haplotype of Spanish patients using single nucleotide polymorphisms(SNPs).Methods:Twenty-seven FHHNC patients were included in this *** analyzed four SNPs located in CLDN19 introns 3 and 4 by polymerase chain reaction amplification and DNA ***:Three new patients with homozygous p.G20D were *** SNP genotyping analysis showed that alleles carrying this mutation shared a common SNP ***:Our findings suggest the existence of a founder effect responsible for FHHNC in our *** for the presence of mutation p.G20D should be the first genetic screening in Spanish patients.

关键词： chronic kidney disease founder effect gene mutation nephrocalcinosis

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Functional physiotherapy method results for the treatment of idiopathic clubfoot

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World Journal of Orthopedics 2019年第6期10卷 235-246页

作者： Noriela Carmen Garcia-Gonzalez Jorge Hodgson-Ravina Armando Aguirre-Jaime servicio de Rehabilitacion Servicio de Ortopedia y TraumatologiaUnidad de Investigacion Clinica y ExperimentalHospital Universitario Nuestra Senora de CandelariaSanta Cruz de Tenerife 38010Spain Colegio de Enfermeria Laureate International UniversitiesSanta Cruz de Tenerife 38001Spain

BACKGROUND Idiopathic clubfoot is a congenital deformity of multifactorial *** initial treatment is eminently conservative;one of the methods applied is the Functional physiotherapy method(FPM),which includes different approaches:Robert debré(RD)and Saint-Vincent-de-Paul(SVP)among *** method is based on manipulations of the foot,bandages,splints and exercises adapted to the motor development of the child aimed to achieve a plantigrade and functional *** hypothesis was that the SVP method could be more efficient than the RD method in correcting deformities,and would decrease the rate of *** To compare the RD and SVP methods,specifically regarding the improvement accomplished and the frequency of surgery needed to achieve a plantigrade *** Retrospective study of 71 idiopathic clubfeet of 46 children born between February 2004 and January 2012,who were evaluated and classified in our hospital according to severity by the Dimeglio-Bensahel *** included moderate,severe and very severe ***-four feet were treated with the RD method and 37 feet with the SVP *** outcomes at a minimum of two years were considered as very good(by physiotherapy),good(by percutaneous heel-cord tenotomy),fair(by limited surgery),and poor(by complete surgery).RESULTS Complete release was not required in any case;limited posterior release was done in 23 cases(74%)with the RD method and 9(25%)with the SVP method(Pdes evidence of the superiority of the SVP method over the RD method,as a variation of the FPM,for the treatment of idiopathic clubfoot.

关键词： Congenital clubfoot Clubfeet Talipes equinovarus Conservative treatment Physical therapy Physiotherapy techniques Conservative methods

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Refractory hepatic encephalopathy in a patient with hypothyroidism: Another element in ammonia metabolism

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World Journal of Gastroenterology 2017年第28期23卷 5246-5252页

作者： Fernando Díaz-Fontenla Marta Castillo-Pradillo Arantxa Díaz-Gómez Luis Ibanez-Samaniego Pilar Gancedo Juan Adan Guzmán-de-Villoria Pilar Fernández-García Rafael Banares-Canizares Rita García-Martínez unidad de Hepatología Servicio de Aparato DigestivoHospital General Universitario Gregorio Maranón Instituto de Investigación Sanitaria Hospital Gregorio Maranón servicio de Aparato Digestivo Hospital Santa Bárbara servicio de Radiodiagnóstico Hospital General Universitario Gregorio Maranón Centro de Investigación Biomédica en Red de Salud Mental Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas Facultad de Medicina Universidad San Pablo CEU

Hepatic encephalopathy(HE) remains a diagnosis of exclusion due to the lack of specific signs and symptoms. Refractory HE is an uncommon but serious condition that requires the search of hidden precipitating events(i.e.,portosystemic shunt) and alternative diagnosis. Hypothyroidism shares clinical manifestations with HE and is usually considered within the differential diagnosis of HE. Here,we describe a patient with refractory HE who presented a large portosystemic shunt and post-ablative hypothyroidism. Her cognitive impairment,hyperammonaemia,electroencephalograph alterations,impaired neuropsychological performance,and magnetic resonance imaging and spectroscopy disturbances were highly suggestive of HE,paralleled the course of hypothyroidism and normalized after thyroid hormone replacement. There was no need for intervention over the portosystemic shunt. The case findings support that hypothyroidism may precipitate HE in cirrhotic patients by inducing hyperammonaemia and/or enhancing ammonia brain toxicity. This case led us to consider hypothyroidism not only in the differential diagnosis but also as a precipitating factor of HE.

关键词： Hepatic encephalopathy Hypothyroidism Cognitive impairment Cirrhosis Portosystemic shunt Magnetic resonance spectroscopy

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ISCHEMIA trial:How to apply the results to clinical practice

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World Journal of Cardiology 2021年第8期13卷 237-242页

作者： Rafael Vidal-Perez Alberto Bouzas-Mosquera Jesus Peteiro Jose Manuel Vazquez-Rodriguez servicio de Cardiologia Unidad de Imagen y Funcion CardiacaComplexo Hospitalario Universitario A Coruna(CHUAC)Centro de Investigacion Biomedica en Red(CIBERCV)-Instituto de Salud Carlos IIIA Coruna 15006Spain servicio de Cardiología Complexo Hospitalario Universitario A CoruñaA Coruña 15006Spain

During the last years two questions have been continuously asked in chronic coronary syndromes:(1)Do revascularization procedures(coronary artery bypass grafting or percutaneous coronary intervention)really improve symptoms of angina?and(2)Do these techniques improve outcomes,*** they prevent new myocardial infarction events and cardiovascular death?Therefore,there was a need for a large definitive *** study was the ISCHEMIA trial,a large,multicentric trial sponsored by the National Heart,Lung,and Blood *** main trial compared coronary revascularization and optimal medical treatment(OMT)vs OMT alone in 5179 patients enrolled after a stress *** a median 3.2-year follow-up,318 primary outcome events occurred;the adjusted hazard ratio for the invasive strategy as compared with the conservative strategy was 0.93(95%confidence interval 0.80-1.08,P=0.34).The ISCHEMIA trial deeply disrupted many of our prior attitudes regarding management strategies for patients with stable coronary artery *** findings underscore the benefits of disease-modifying OMT for stable coronary artery disease *** main purposes of ischemia assessment before this trial were:Diagnostic purposes,assessment of outcome,and adding to decision-making ***,this changed after the trial *** results of ISCHEMIA might challenge the current diagnostic approach for stable angina patients recommended in the last European Society of Cardiology guidelines on chronic coronary disease that were based on studies published before the ISCHEMIA *** this editorial we propose our approach based on the ISCHEMIA study and the pretest probability for a positive test in patients with chronic coronary syndromes.

关键词： Stable angina Chronic coronary syndrome ISCHEMIA Stress testing Therapy Diagnosis

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