1.Microbiome-centered therapies for the management of metabolic dysfunction-associated steatotic liver disease
Huma SAEED ; Luis Antonio DÍAZ ; Antonio GIL-GÓMEZ ; Jeremy BURTON ; Jasmohan S. BAJAJ ; Manuel ROMERO-GOMEZ ; Marco ARRESE ; Juan Pablo ARAB ; Mohammad Qasim KHAN
Clinical and Molecular Hepatology 2025;31(Suppl):S94-S111
Metabolic dysfunction-associated steatotic liver disease (MASLD) is a significant global health issue, affecting over 30% of the population worldwide due to the rising prevalence of metabolic risk factors such as obesity and type 2 diabetes mellitus. This spectrum of liver disease ranges from isolated steatosis to more severe forms such as steatohepatitis, fibrosis, and cirrhosis. Recent studies highlight the role of gut microbiota in MASLD pathogenesis, showing that dysbiosis significantly impacts metabolic health and the progression of liver disease. This review critically evaluates current microbiome-centered therapies in MASLD management, including prebiotics, probiotics, synbiotics, fecal microbiota transplantation, and emerging therapies such as engineered bacteria and bacteriophage therapy. We explore the scientific rationale, clinical evidence, and potential mechanisms by which these interventions influence MASLD. The gut-liver axis is crucial in MASLD, with notable changes in microbiome composition linked to disease progression. For instance, specific microbial profiles and reduced alpha diversity are associated with MASLD severity. Therapeutic strategies targeting the microbiome could modulate disease progression by improving gut permeability, reducing endotoxin-producing bacteria, and altering bile acid metabolism. Although promising, these therapies require further research to fully understand their mechanisms and optimize their efficacy. This review integrates findings from clinical trials and experimental studies, providing a comprehensive overview of microbiome-centered therapies’ potential in managing MASLD. Future research should focus on personalized strategies, utilizing microbiome features, blood metabolites, and customized dietary interventions to enhance the effectiveness of these therapies.
2.Microbiome-centered therapies for the management of metabolic dysfunction-associated steatotic liver disease
Huma SAEED ; Luis Antonio DÍAZ ; Antonio GIL-GÓMEZ ; Jeremy BURTON ; Jasmohan S. BAJAJ ; Manuel ROMERO-GOMEZ ; Marco ARRESE ; Juan Pablo ARAB ; Mohammad Qasim KHAN
Clinical and Molecular Hepatology 2025;31(Suppl):S94-S111
Metabolic dysfunction-associated steatotic liver disease (MASLD) is a significant global health issue, affecting over 30% of the population worldwide due to the rising prevalence of metabolic risk factors such as obesity and type 2 diabetes mellitus. This spectrum of liver disease ranges from isolated steatosis to more severe forms such as steatohepatitis, fibrosis, and cirrhosis. Recent studies highlight the role of gut microbiota in MASLD pathogenesis, showing that dysbiosis significantly impacts metabolic health and the progression of liver disease. This review critically evaluates current microbiome-centered therapies in MASLD management, including prebiotics, probiotics, synbiotics, fecal microbiota transplantation, and emerging therapies such as engineered bacteria and bacteriophage therapy. We explore the scientific rationale, clinical evidence, and potential mechanisms by which these interventions influence MASLD. The gut-liver axis is crucial in MASLD, with notable changes in microbiome composition linked to disease progression. For instance, specific microbial profiles and reduced alpha diversity are associated with MASLD severity. Therapeutic strategies targeting the microbiome could modulate disease progression by improving gut permeability, reducing endotoxin-producing bacteria, and altering bile acid metabolism. Although promising, these therapies require further research to fully understand their mechanisms and optimize their efficacy. This review integrates findings from clinical trials and experimental studies, providing a comprehensive overview of microbiome-centered therapies’ potential in managing MASLD. Future research should focus on personalized strategies, utilizing microbiome features, blood metabolites, and customized dietary interventions to enhance the effectiveness of these therapies.
3.Microbiome-centered therapies for the management of metabolic dysfunction-associated steatotic liver disease
Huma SAEED ; Luis Antonio DÍAZ ; Antonio GIL-GÓMEZ ; Jeremy BURTON ; Jasmohan S. BAJAJ ; Manuel ROMERO-GOMEZ ; Marco ARRESE ; Juan Pablo ARAB ; Mohammad Qasim KHAN
Clinical and Molecular Hepatology 2025;31(Suppl):S94-S111
Metabolic dysfunction-associated steatotic liver disease (MASLD) is a significant global health issue, affecting over 30% of the population worldwide due to the rising prevalence of metabolic risk factors such as obesity and type 2 diabetes mellitus. This spectrum of liver disease ranges from isolated steatosis to more severe forms such as steatohepatitis, fibrosis, and cirrhosis. Recent studies highlight the role of gut microbiota in MASLD pathogenesis, showing that dysbiosis significantly impacts metabolic health and the progression of liver disease. This review critically evaluates current microbiome-centered therapies in MASLD management, including prebiotics, probiotics, synbiotics, fecal microbiota transplantation, and emerging therapies such as engineered bacteria and bacteriophage therapy. We explore the scientific rationale, clinical evidence, and potential mechanisms by which these interventions influence MASLD. The gut-liver axis is crucial in MASLD, with notable changes in microbiome composition linked to disease progression. For instance, specific microbial profiles and reduced alpha diversity are associated with MASLD severity. Therapeutic strategies targeting the microbiome could modulate disease progression by improving gut permeability, reducing endotoxin-producing bacteria, and altering bile acid metabolism. Although promising, these therapies require further research to fully understand their mechanisms and optimize their efficacy. This review integrates findings from clinical trials and experimental studies, providing a comprehensive overview of microbiome-centered therapies’ potential in managing MASLD. Future research should focus on personalized strategies, utilizing microbiome features, blood metabolites, and customized dietary interventions to enhance the effectiveness of these therapies.
4.Implementation of Society for Cardiovascular Angiography and Interventions classification in patients with cardiogenic shock secondary to acute myocardial infarction in a spanish university hospital
Javier Pérez CERVERA ; Carlos Antonio Aranda LÓPEZ ; Rosa Navarro ROMERO ; Javier Corral MACÍAS ; Juan Manuel Nogales ASENSIO ; José Ramón López MÍNGUEZ
Acute and Critical Care 2024;39(2):257-265
Killip-Kimball classification has been used for estimating death risk in patients suffering acute myocardial infarction (AMI). Killip-Kimball stage IV corresponds to cardiogenic shock. However, the Society for Cardiovascular Angiography and Interventions (SCAI) classification provides a more precise tool to classify patients according to shock severity. The aim of this study was to apply this classification to a cohort of Killip IV patients and to analyze the differences in death risk estimation between the two classifications. Methods: A single-center retrospective cohort study of 100 consecutive patients hospitalized for “Killip IV AMI” between 2016 and 2023 was performed to reclassify patients according to SCAI stage. Results: Distribution of patients according to SCAI stages was B=4%, C=53%, D=27%, E=16%. Thirty-day mortality increased progressively according to these stages (B=0%, C=11.88%, D=55.56%, E=87.50%; P<0.001). The exclusive use of Killip IV stage overestimated death risk compared to SCAI C (35% vs. 11.88%, P=0.002) and underestimated it compared to SCAI D and E stages (35% vs. 55.56% and 87.50%, P=0.03 and P<0.001, respectively). Age >69 years, creatinine >1.15 mg/dl and advanced SCAI stages (SCAI D and E) were independent predictors of 30-day mortality. Mechanical circulatory support use showed an almost significant benefit in advanced SCAI stages (D and E hazard ratio, 0.45; 95% confidence interval, 0.19–1.06; P=0.058). Conclusions: SCAI classification showed superior death risk estimation compared to Killip IV. Age, creatinine levels and advanced SCAI stages were independent predictors of 30-day mortality. Mechanical circulatory support could play a beneficial role in advanced SCAI stages.
5.Implementation of Society for Cardiovascular Angiography and Interventions classification in patients with cardiogenic shock secondary to acute myocardial infarction in a spanish university hospital
Javier Pérez CERVERA ; Carlos Antonio Aranda LÓPEZ ; Rosa Navarro ROMERO ; Javier Corral MACÍAS ; Juan Manuel Nogales ASENSIO ; José Ramón López MÍNGUEZ
Acute and Critical Care 2024;39(2):257-265
Killip-Kimball classification has been used for estimating death risk in patients suffering acute myocardial infarction (AMI). Killip-Kimball stage IV corresponds to cardiogenic shock. However, the Society for Cardiovascular Angiography and Interventions (SCAI) classification provides a more precise tool to classify patients according to shock severity. The aim of this study was to apply this classification to a cohort of Killip IV patients and to analyze the differences in death risk estimation between the two classifications. Methods: A single-center retrospective cohort study of 100 consecutive patients hospitalized for “Killip IV AMI” between 2016 and 2023 was performed to reclassify patients according to SCAI stage. Results: Distribution of patients according to SCAI stages was B=4%, C=53%, D=27%, E=16%. Thirty-day mortality increased progressively according to these stages (B=0%, C=11.88%, D=55.56%, E=87.50%; P<0.001). The exclusive use of Killip IV stage overestimated death risk compared to SCAI C (35% vs. 11.88%, P=0.002) and underestimated it compared to SCAI D and E stages (35% vs. 55.56% and 87.50%, P=0.03 and P<0.001, respectively). Age >69 years, creatinine >1.15 mg/dl and advanced SCAI stages (SCAI D and E) were independent predictors of 30-day mortality. Mechanical circulatory support use showed an almost significant benefit in advanced SCAI stages (D and E hazard ratio, 0.45; 95% confidence interval, 0.19–1.06; P=0.058). Conclusions: SCAI classification showed superior death risk estimation compared to Killip IV. Age, creatinine levels and advanced SCAI stages were independent predictors of 30-day mortality. Mechanical circulatory support could play a beneficial role in advanced SCAI stages.
6.Implementation of Society for Cardiovascular Angiography and Interventions classification in patients with cardiogenic shock secondary to acute myocardial infarction in a spanish university hospital
Javier Pérez CERVERA ; Carlos Antonio Aranda LÓPEZ ; Rosa Navarro ROMERO ; Javier Corral MACÍAS ; Juan Manuel Nogales ASENSIO ; José Ramón López MÍNGUEZ
Acute and Critical Care 2024;39(2):257-265
Killip-Kimball classification has been used for estimating death risk in patients suffering acute myocardial infarction (AMI). Killip-Kimball stage IV corresponds to cardiogenic shock. However, the Society for Cardiovascular Angiography and Interventions (SCAI) classification provides a more precise tool to classify patients according to shock severity. The aim of this study was to apply this classification to a cohort of Killip IV patients and to analyze the differences in death risk estimation between the two classifications. Methods: A single-center retrospective cohort study of 100 consecutive patients hospitalized for “Killip IV AMI” between 2016 and 2023 was performed to reclassify patients according to SCAI stage. Results: Distribution of patients according to SCAI stages was B=4%, C=53%, D=27%, E=16%. Thirty-day mortality increased progressively according to these stages (B=0%, C=11.88%, D=55.56%, E=87.50%; P<0.001). The exclusive use of Killip IV stage overestimated death risk compared to SCAI C (35% vs. 11.88%, P=0.002) and underestimated it compared to SCAI D and E stages (35% vs. 55.56% and 87.50%, P=0.03 and P<0.001, respectively). Age >69 years, creatinine >1.15 mg/dl and advanced SCAI stages (SCAI D and E) were independent predictors of 30-day mortality. Mechanical circulatory support use showed an almost significant benefit in advanced SCAI stages (D and E hazard ratio, 0.45; 95% confidence interval, 0.19–1.06; P=0.058). Conclusions: SCAI classification showed superior death risk estimation compared to Killip IV. Age, creatinine levels and advanced SCAI stages were independent predictors of 30-day mortality. Mechanical circulatory support could play a beneficial role in advanced SCAI stages.
7.Implementation of Society for Cardiovascular Angiography and Interventions classification in patients with cardiogenic shock secondary to acute myocardial infarction in a spanish university hospital
Javier Pérez CERVERA ; Carlos Antonio Aranda LÓPEZ ; Rosa Navarro ROMERO ; Javier Corral MACÍAS ; Juan Manuel Nogales ASENSIO ; José Ramón López MÍNGUEZ
Acute and Critical Care 2024;39(2):257-265
Killip-Kimball classification has been used for estimating death risk in patients suffering acute myocardial infarction (AMI). Killip-Kimball stage IV corresponds to cardiogenic shock. However, the Society for Cardiovascular Angiography and Interventions (SCAI) classification provides a more precise tool to classify patients according to shock severity. The aim of this study was to apply this classification to a cohort of Killip IV patients and to analyze the differences in death risk estimation between the two classifications. Methods: A single-center retrospective cohort study of 100 consecutive patients hospitalized for “Killip IV AMI” between 2016 and 2023 was performed to reclassify patients according to SCAI stage. Results: Distribution of patients according to SCAI stages was B=4%, C=53%, D=27%, E=16%. Thirty-day mortality increased progressively according to these stages (B=0%, C=11.88%, D=55.56%, E=87.50%; P<0.001). The exclusive use of Killip IV stage overestimated death risk compared to SCAI C (35% vs. 11.88%, P=0.002) and underestimated it compared to SCAI D and E stages (35% vs. 55.56% and 87.50%, P=0.03 and P<0.001, respectively). Age >69 years, creatinine >1.15 mg/dl and advanced SCAI stages (SCAI D and E) were independent predictors of 30-day mortality. Mechanical circulatory support use showed an almost significant benefit in advanced SCAI stages (D and E hazard ratio, 0.45; 95% confidence interval, 0.19–1.06; P=0.058). Conclusions: SCAI classification showed superior death risk estimation compared to Killip IV. Age, creatinine levels and advanced SCAI stages were independent predictors of 30-day mortality. Mechanical circulatory support could play a beneficial role in advanced SCAI stages.
8.A fecalith mimicking a bladder calculus secondary to an appendicovesical fistula: a case report
Mauricio GONZALEZ-URQUIJO ; Andrea ROMERO-DAVILA ; MaryCarmen MENDOZA-SILVA ; Antonio Nassim Halun TREVIÑO ; Mario RODARTE-SHADE ; Gerardo GIL-GALINDO
Annals of Coloproctology 2023;39(4):362-365
An appendicovesical fistula is defined as an abnormal communication between the appendix and the urinary bladder, with only a few cases reported in the literature. It is very challenging to make an early diagnosis, due to the inability of conventional imaging modalities to detect this unique pathology. The symptoms are often mild, and there are not any specific signs or symptoms that might suggest this type of anomalous communication. We report a case of a 27-year-old male patient who presented difficulty for initiating urination, dysuria, and persistent urinary tract infections. An abdominal x-ray showed a large calculus inside the bladder. A cystoscopy was performed, where the tip of the appendix was seen protruding inside the bladder with a large fecalith adhered to the bladder wall. An appendectomy and partial cystectomy with primary repair were auspiciously achieved. A review of the literature is also presented.
9.Molecular diversity of the VP2 of Carnivore protoparvovirus 1 (CPV-2) of fecal samples from Bogotá
Cristian Camilo GALVIS ; Tatiana JIMENEZ-VILLEGAS ; Diana Patricia REYES ROMERO ; Alejandro VELANDIA ; Sueli TANIWAKI ; Sheila Oliveira de SOUZA SILVA ; Paulo BRANDÃO ; Nelson Fernando SANTANA-CLAVIJO
Journal of Veterinary Science 2022;23(1):e14-
Background:
Carnivore protoparvovirus 1, also known as canine parvovirus type 2 (CPV-2), is the main pathogen in hemorrhagic gastroenteritis in dogs, with a high mortality rate. Three subtypes (a, b, c) have been described based on VP2 residue 426, where 2a, 2b, and 2c have asparagine, aspartic acid, and glutamic acid, respectively.
Objectives:
This study examined the presence of CPV-2 variants in the fecal samples of dogs diagnosed with canine parvovirus in Bogotá.
Methods:
Fecal samples were collected from 54 puppies and young dogs (< 1 year) that tested positive for the CPV through rapid antigen test detection between 2014–2018. Molecular screening was developed for VP1 because primers 555 for VP2 do not amplify, it was necessary to design a primer set for VP2 amplification of 982 nt. All samples that were amplified were sequenced by Sanger. Phylogenetics and structural analysis was carried out, focusing on residue 426.
Results:
As a result 47 out of 54 samples tested positive for VP1 screening, and 34/47 samples tested positive for VP2 980 primers as subtype 2a (n = 30) or 2b (n = 4); subtype 2c was not detected. All VP2 sequences had the amino acid, T, at 440, and most Colombian sequences showed an S514A substitution, which in the structural modeling is located in an antigenic region, together with the 426 residue.
Conclusions
The 2c variant was not detected, and these findings suggest that Colombian strains of CPV-2 might be under an antigenic drift.
10. Prevalence and intensity of soil-transmitted helminth infections among school-age children in the Cagayan Valley, the Philippines
Ryan LABANA ; Vimar ROMERO ; Analette GUINTO ; Alvin CARIL ; Kimberly UNTALAN ; Alejandro REBOA ; Lanieleen Jerah AROCHA ; Khristine SANDOVAL ; Kristel Joy CADA ; Gary Antonio LIRIO ; Iris Rowena BERNARDO ; Julieta DUNGCA
Asian Pacific Journal of Tropical Medicine 2021;14(3):113-121
Objective: To identify the prevalence of soil-transmitted helminthiasis (STH) among school-age children in the Cagayan Valley, the Philippines, assess their level of awareness on the disease, and determine predisposing factors of the disease. Methods: A total of 478 Grades III-V school-age children in Pamplona and Sanchez-Mira School Districts in the Cagayan Valley answered the questionnaire assessing their knowledge, attitude, and practices on STH, subjected to anthropometric measurements, and provided faecal samples for parasitologic assessment (direct smear, Kato-Katz, and formol-ether concentration techniques). Results: The participants of the study, with 55.86% females, were 8 to 14 years old. Their nutritional status was assessed 'normal' (84.31%), 'severely wasted' (6.49%), 'wasted' (5.23%), 'overweight' (2.72%), and 'obese' (1.26%). The prevalence of infection with at least 1 STH species was 25.99% in Pamplona and 19.40% in Sanchez- Mira. Overall, the prevalence of heavy intensity was 7.11% for Ascaris lumbricoides and 1.67% for Trichuris trichiura. All hookworm infections had light intensities. The majority of the school-age children had a low score in the KAP test. In knowledge of STH, 'stunted growth as a symptom of infection' was associated with a lower risk of Ascaris lumbricoides infection (OR 0.448; 95% CI 0.212, 0.945; P=0.035) while 'playing with soil as a mode of transmission' was associated with an increased risk of Ascaris lumbricoides infection (OR 2.067; 95% CI 1.014, 4.212; P=0.046). In attitude towards STH, 'I think I have intestinal worm now' was associated with a higher risk of Ascaris lumbricoides infection (OR 1.681; 95% CI 1.061, 2.662; P=0.027). Conclusions: The prevalence rate of Ascaris lumbricoides among the school-age children in the Cagayan Valley shows the need to further intensify intervention in the area to meet the threshold set by the World Health Organization. The identified predictors of infection, which concerns the school-age children's knowledge and attitude toward STH, can be used in augmenting intervention programs in the future.

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