Subclinical versus advanced forms of alcohol-related liver disease: Need for early detection

Concepción Gómez-Medina,Luma Melo,David Martí-Aguado,Ramón Bataller 대한간학회 2023 Clinical and Molecular Hepatology(대한간학회지) Vol.29 No.1

Alcohol-related liver disease (ALD) consists of a wide spectrum of clinical manifestations and pathological features, ranging from asymptomatic patients to decompensated cirrhosis and hepatocellular carcinoma. Patients with heavy alcohol intake and advanced fibrosis often develop a subacute form of liver failure called alcohol-induced hepatitis (AH). Globally, most patients with ALD are identified at late stages of the disease, limiting therapeutic interventions. Thus, there is a need for early detection of ALD patients, which is lacking in most countries. The identification of alcohol misuse is hampered by the existence of alcohol underreporting by many patients. There are useful biomarkers that can detect recent alcohol use. Moreover, there are several non-invasive techniques to assess the presence of advanced fibrosis among patients with alcohol misuse, which could identify patients at high risk of liver related events or early death. In this review, we discuss differences between early stages of ALD and AH as the cornerstone of advanced forms. A global overview of epidemiological, anthropometric, clinical, analytical, histological, and molecular differences is summarized in this article. We propose that campaigns aimed at identifying patients with subclinical forms can prevent the development of life-threatening forms.

FE Model of Three-Dimensional Steel Beam-to-Column Bolted Extended End-Plate Joint

Concepción Díaz,Mariano Victoria,Osvaldo M. Querin,Pascual Martí 한국강구조학회 2018 International Journal of Steel Structures Vol.18 No.3

The rotational behaviour of three-dimensional steel end-plate connections can be studied using the fi nite element method for the following four reasons: (1) such models are inexpensive and robust; (2) they allow the understanding of local eff ects; (3) they can be used to generate extensive parametric studies; (4) current version of the component method lacks the appropriate components to predict the behaviour of minor-axis and three-dimensional joints. This work presents a full ANSYS fi nite element parametric model of a three-dimensional steel beam-to-column bolted extended end-plate joint in both axes for use to obtain their behaviour. The model allows to study four joint confi gurations (internal, external, corner, and plane) and includes: contact and sliding between diff erent elements; bolt-pretension, and geometric and material non-linearity. This model was calibrated and validated with experimental results found in the literature. The results from the fi nite element analysis were verifi ed by comparing the obtained moment–rotation curve of the joint. Three parametric studies are presented to show the versatility of the FE model. The results were compared with those obtained with the model proposed by Eurocode 3. The developed ANSYS FE model can be downloaded for free as a single ZIP compressed fi le from the Technical University of Cartagena (UPCT): http://www.upct.es/goe/publi cacio nes/FEM_3D_EEP.zip .

Cushing disease in pediatrics: an update

Concepción-Zavaleta Marcio José,Armas Cristian David,Quiroz-Aldave Juan Eduardo,García-Villasante Eilhart Jorge,Gariza-Solano Ana Cecilia,Durand-Vásquez María del Carmen,Concepción-Urteaga Luis Albert 대한소아내분비학회 2023 Annals of Pediatirc Endocrinology & Metabolism Vol.28 No.2

Cushing disease (CD) is the main cause of endogenous Cushing syndrome (CS) and is produced by an adrenocorticotropic hormone (ACTH)-producing pituitary adenoma. Its relevance in pediatrics is due to the retardation of both growth and developmental processes because of hypercortisolism. In childhood, the main features of CS are facial changes, rapid or exaggerated weight gain, hirsutism, virilization, and acne. Endogenous hypercortisolism should be established after exogenous CS has been ruled out based on 24-hour urinary free cortisol, midnight serum or salivary cortisol, and dexamethasone suppression test; after that, ACTH dependence should be established. The diagnosis should be confirmed by pathology. The goal of treatment is to normalize cortisol level and reverse the signs and symptoms. Treatment options include surgery, medication, radiotherapy, or combined therapy. CD represents a challenge for physicians owing to its multiple associated conditions involving growth and pubertal development; thus, it is important to achieve an early diagnosis and treatment in order to control hypercortisolism and improve the prognosis. Its rarity in pediatric patients has led physicians to have limited experience in its management. The objective of this narrative review is to summarize the current knowledge about the pathophysiology, diagnosis, and treatment of CD in the pediatric population.

Effect of stress during slaughter on carcass characteristics and meat quality in tropical beef cattle

Carrasco-García Apolo A.,Pardío-Sedas Violeta T.,León-Banda Gloria G.,Ahuja-Aguirre Concepción,Paredes-Ramos Pedro,Hernández-Cruz Bertha C.,Murillo Vicente Vega 아세아·태평양축산학회 2020 Animal Bioscience Vol.33 No.10

Objective: This study aimed to determine the effects of stress during slaughter of beef cattle on physiological parameters, carcass, and meat quality at a Federal Inspection Type slaughterhouse located in the southeast of Mexico. Methods: A total of 448 carcasses of male Zebu×European steers with an average age of 36 months were included. Carcass assessment of presence of bruises and bruise characteristics was carried out on each half-carcass. Blood variable indicators of stress (packed cell volume, neutrophil to lymphocyte ratio, glucose, cortisol concentration) and meat quality parameters (pH, color, shear force, drip loss) were evaluated. Results: Of the 448 carcasses evaluated, 81% of the carcasses showed at least one bruise; one bruise was detected in 36.6% and two bruises in 27.0% of animals. Of the 775 bruises found, 69.2% of the bruises were grade 1 in region 3. Of the 448 carcasses studied, 69.6% showed hyperglycemia (6.91 mmol/L); 44.3% and 22.7% showed high (74.7 ng/mL) and extremely high (108.8 ng/mL) cortisol levels, respectively, indicative of inadequate handling of animals during preslaughter and slaughter. Of the carcasses evaluated, 90.4% had a pH ≥5.8 with an average of pH 6.3. In both pH groups, meat samples showed L* values >37.0 (81.6%) and a shear force >54.3 N; meat pH≥5.8 group showed a drip loss of 2.5%. These findings were indicative of dark, firm, and dry (DFD) meat. According to principal component analysis, grades 1 and 2 bruises in region 3 and grade 1 bruises in region 5 were highly associated with cortisol, drip loss, and color parameters b* and h* and were negatively associated with L*, a*, and C*. Conclusion: The bruises probably caused by stress-inducing situations triggered DFD meat. Appropriate changes in handling routines in operating conditions should be made to minimize stress to animals during the slaughter process to improve animal welfare and meat quality.

Combination of Soy Isoflavones, 8-Prenylnaringenin and Melatonin Improves Hot Flashes and Health-Related Quality of Life Outcomes in Postmenopausal Women: Flavie Study

Carmela Puchol Estrugo,Miriam Trujillo Rodríguez,Nicolás Mendoza-Ladrón de Guevara,Joaquín Grande Gómez,Francisca Ridocci,Maria Teresa Moro-Martín,Misericordia Guinot,Paula Saz-Leal,Concepción Nieto M 대한폐경학회 2023 대한폐경학회지 Vol.29 No.2

Objectives: This study aims to investigate the effects of a combination of soy isoflavones, 8-prenylnaringenin (8-PN), and melatonin in postmenopausal women suffering from moderate-to-severe hot flashes (HFs).Methods: A multicenter, prospective, open-label study enrolled 44 postmenopausal women suffering from moderate-to-severe HFs (≥ 5 daily or ≥ 35 weekly) to receive 54.4 mg standardized soy isoflavones (including 24.5 mg genistein and 16.3 mg daidzein), 100 µg 8-PN, and 1 mg melatonin once daily for 12 weeks. The primary clinical outcomes included changes in health-related quality of life (HRQoL) scores (Menopause-Specific QoL questionnaire [MENQoL] and Cervantes Scale) and HFs following 4 and 12 weeks of treatment. Other analyses included treatment adherence, acceptability, tolerability, and safety.Results: All of the four domains of MENQoL questionnaire significantly improved at 4 weeks (P < 0.05) and 12 weeks (P < 0.001), affecting significantly the vasomotor, psychosocial, and physical spheres (41.2%, 26.3%, and 25.0%; 12 weeks improvements, respectively). Similarly, in the menopause (39.3%) and psychic (51.7%) domains (both P < 0.05 at 12 weeks), the global score of the Cervantes Scale significantly increased at 4 weeks (18.6%) and 12 weeks (35.4%). Accordingly, moderate-to-severe HFs significantly decreased at 4 weeks compared to baseline (41.7% reduction) and further reduced at 12 weeks (76.5%), including the total number of episodes.Conclusions: Food supplements containing soy isoflavones, 8-PN, and melatonin showed an early and progressive benefit for reducing clinically significant HFs and for improving HRQoL across all domains, favorably affecting postmenopausal women’s overall well-being.

Osteomyelitis: A Descriptive Study

Laura Prieto-Pérez,Ramón Pérez-Tanoira,Elizabet Petkova-Saiz,Concepción Pérez-Jorge,Cristina Lopez-Rodriguez,Beatriz Alvarez-Alvarez,Jorge Polo-Sabau,Jaime Esteban 대한정형외과학회 2014 Clinics in Orthopedic Surgery Vol.6 No.1

Background: To analyze the incidence and clinical-microbiological characteristics of osteomyelitis (OM) in a tertiary Spanish hospital. Methods: All cases diagnosed with OM between January 2007 and December 2010 were retrospectively reviewed. The variablesexamined include epidemiological characteristics, risk factors, affected bone, radiographic changes, histology, microbiological cultureresults, antibiotic treatment, and the need for surgery. Results: Sixty-three cases of OM were diagnosed. Twenty-six patients (41.3%) had acute OM whereas 37 patients (58.7%) wereclassified as chronic OM. OM may result from haematogenous or contiguous microbial seeding. In this group, 49 patients (77.8%)presented with OM secondary to a contiguous source of infection and 14 patients had hematogenous OM (22.2%). Staphylococcusaureus was the most commonly found microorganism. Conclusions: OM mainly affected patients with risk factors related to the presence of vascular diseases. Antibiotic treatmentmust be guided by susceptibility patterns of individual microorganisms, although it must be performed together with surgery inmost of the cases.

Stemphylium Leaf Blight of Garlic (Allium sativum ) in Spain: Taxonomy and In Vitro Fungicide Response

Laura Gálvez,Jéssica Gil-Serna,Marta García,Concepción Iglesias,Daniel Palmero 한국식물병리학회 2016 Plant Pathology Journal Vol.32 No.5

The most serious aerial disease of garlic is leaf blightcaused by Stemphylium spp. Geographical variation inthe causal agent of this disease is indicated. Stemphyliumvesicarium has been reported in Spain, whereas S. solani is the most prevalent species recorded in China. In this study, Stemphylium isolates were obtainedfrom symptomatic garlic plants sampled from themain Spanish production areas. Sequence data for theITS1–5.8S–ITS2 region enabled assignation of the isolatesto the Pleospora herbarum complex and clearlydistinguished the isolates from S. solani. Conidial morphologyof the isolates corresponded to that of S. vesicariumand clearly discriminated them from S. alfalfaeand S. herbarum on the basis of the size and septationpattern of mature conidia. Conidial morphology aswell as conidial length, width and length:width ratioalso allowed the Spanish isolates to be distinguishedfrom S. botryosum and S. herbarum. Control of leafblight of garlic is not well established. Few studies areavailable regarding the effectiveness of chemical treatmentsto reduce Stemphylium spp. incidence on garlic. The effectiveness of nine fungicides of different chemicalgroups to reduce Stemphylium mycelial growthin vitro was tested. Boscalid + pyraclostrobin (groupname, succinate dehydrogenase inhibitors + quinoneoutside inhibitors), iprodione (dicar-boximide), andprochloraz (demethylation inhibitors) were highlyeffectiveat reducing mycelial growth in S. vesicariumwith EC50 values less than 5 ppm. In general, the effectivenessof the fungicide was enhanced with increasingdosage.

Early Effect of 0.005% Estriol Vaginal Gel on Symptoms and Signs of Vulvovaginal Atrophy

Lázaro-Carrasco de la Fuente Jesús,Cuerva González Marcos,González Rodríguez Silvia,Delgado Marín Juan Luis,Cuevas Castillo Carmen,Nieto Magro Concepción 대한폐경학회 2022 대한폐경학회지 Vol.28 No.2

Objectives: This study aims to assess the effect of ultralow dose 0.005% estriol vaginal gel in women with genitourinary syndrome of menopause (GSM).Methods: In this prospective and multicenter single-arm study, efficacy was assessed by the evaluation of the epithelial maturation value (MV), vaginal pH, symptoms and signs of vulvovaginal atrophy. Tolerability, acceptability, and the effect on intimate relationships were also evaluated.Results: We included 35 postmenopausal women with moderate-to-severe vaginal dryness. The most bothering symptom reported was vaginal dryness. The mean increase in the MV after 7 and 14 days of treatment were 22.1 (P < 0.001) and 39.9 (P < 0.001) points, with an increase in the superficial cells of 17.7 percentage points (pp) (95% confidence interval [CI], 7.9–27.4; P < 0.001) and 41.4 pp (95% CI, 28.2–54.6; P < 0.001) observed at the timepoints. Additionally, the pH decreased by 0.6 ± 0.7 (mean ± SD) at 7 days (P < 0.0001) and by 1.1 ± 0.8 at 14 days (P < 0.0001) from a baseline mean value of 6.3 ± 0.8. The severity of vaginal dryness (range, 0 [none] to 3 [severe]) was significantly reduced by a mean of 1.4 points (P < 0.0001) at 7 days and 2 points (P < 0.0001) at 14 days. Conclusions: Ultralow dose 0.005% estriol vaginal gel produced a rapid improvement of most relevant symptoms and signs of GSM. This clinically meaningful response was observed from the initial days of treatment, confirming a fast onset and a progressive action.

Safety of Nonoperative Management After Acute Diverticulitis

Javier Suarez Alecha,Sonia Amoza Pais,Xavi Batlle Marin,Begoña Oronoz Martinez,Enrique Balen Ribera,Concepción Yarnoz Irazabal 대한대장항문학회 2014 Annals of Coloproctolgy Vol.30 No.5

Purpose: The role of surgery in the management of diverticular disease after an episode of acute diverticulitis (AD) managed in a conservative form is evolving. Age, number of episodes of AD, type of episode, and symptoms after the episodes are factors related to the need for elective surgery. The aim of this study is to evaluate the safety of conservative management and the risk factors for emergency surgery after a first episode of AD managed without surgery. Methods: We retrospectively evaluated 405 patients diagnosed as having had a first episode of AD. Sixty-nine patients underwent emergency surgery on the first admission, and 69 patients had an elective operation in the follow-up (group A). The remaining 267 patients were managed initially without surgery (group B). Thirteen of these 267 patients needed a further urgent surgical procedure. Factors involved in the decision of elective surgery and the probability of emergency surgery after the first episode of AD managed without surgery were evaluated in relation to demographic factors, risk factors, presence of recurrences, and type of the first episode. Results: Patients, mean age was 62.7 years, 71 were aged less than 51, and 151 were males. The mean follow-up for patients with nonoperative management was 91.2 months. An elective operation was performed in 69 patients. Compared to patients in group B, those in group A more frequently had a first episode of complicated acute diverticulitis (CAD) (37.1% vs. 16.4%; P = 0.000) and were more likely to be smokers (46.3% vs. 19.3%; P = 0.000) and to suffer more than one episode of AD (42% vs. 26.9%; P = 0.027). Nonoperative management was chosen for 267 patients, but 13 patients needed an emergency operation later. In the multivariate analysis, we found a significant relation between the presence of CAD in the first episode and the need for emergency surgery. There were no differences in surgical mortality between the patients in the two groups, but patients treated with elective surgery had a higher rate of stoma than patients treated non-operatively (7.2% vs. 1.4%; P = 0.028); this difference was not observed in the subgroup of patients with CAD (15.3% vs. 6.8%; P = 0.458). Conclusion: After an episode of AD, nonoperative management is safe because fewer than 5% of patients will need an emergent procedure in a subsequent attack of AD. A first episode of CAD is the only risk factor for emergency surgery in patients managed conservatively.

Early response with dasatinib or imatinib in chronic myeloid leukemia: 3-year follow-up from a randomized phase 3 trial (DASISION)

Jabbour, Elias,Kantarjian, Hagop M.,Saglio, Giuseppe,Steegmann, Juan Luis,Shah, Neil P.,Boqué,, Concepció,n,Chuah, Charles,Pavlovsky, Carolina,Mayer, Jiř,í,Cortes, Jorge,Baccara American Society of Hematology 2014 Blood Vol.123 No.4

<P>This analysis explores the impact of early cytogenetic and molecular responses on the outcomes of patients with chronic myeloid leukemia in chronic phase (CML-CP) in the phase 3 DASatinib versus Imatinib Study In treatment-Naive CML patients trial with a minimum follow-up of 3 years. Patients with newly diagnosed CML-CP were randomized to receive 100 mg dasatinib (n = 259) or 400 mg imatinib (n = 260) once daily. The retrospective landmark analysis included patients evaluable at the relevant time point (3, 6, or 12 months). Median time to complete cytogenetic response was 3 vs 6 months with dasatinib vs imatinib. At 3 and 6 months, the proportion of patients with BCR-ABL transcript levels ≤10% was higher in the dasatinib arm. Deeper responses at 3, 6, and 12 months were observed in a higher proportion of patients on dasatinib therapy and were associated with better 3-year progression-free survival and overall survival in both arms. First-line dasatinib resulted in faster and deeper responses compared with imatinib. The achievement of an early molecular response was predictive of improved progression-free survival and overall survival, supporting new milestones for optimal response in patients with early CML-CP treated with tyrosine kinase inhibitors. This study was registered at www.clinicaltrials.gov as NCT00481247.</P>