Bøger af Luis Rodrigo

The intestine is the largest digestive organ in the human body and one of the largest organs in contact with the outside world. In addition to digesting food to facilitate the absorption of nutrients, it has a variety of other functions, including the transmission of information and regulation of the metabolism. Due to its unique structure, the intestine is constantly exposed to various antigens and microbes. To protect the body from pathogens, while also maintaining a stable environment, the human intestinal tract has evolved unique regional immune characteristics maintained by the mature intestinal mucosal immune system. This intricate system involves intestinal epithelial cells, and intestinal lymphoid tissue composed of Peyer¿s patches, isolated lymphoid follicles, mesenteric lymph nodes, and so on. The congenital and adaptive immune mechanisms created by the unique structure, function, and microenvironment of the intestine differ from those of the central and peripheral immune organs forming the regional immunity of the intestine. Intestinal flora also plays an important role in maintaining intestinal homeostasis, altering the structure and function of the immune system, reshaping the immune microenvironment, and promoting interference with the development of specific diseases. In fact, the immune function of the intestinal region directly affects the development of many intestine-specific diseases. However, the integrity of this function depends on the expression of congenital genes and the regulation of the neuroendocrine system. The microenvironment created by intestinal flora and its products also affects the immunity of the intestinal region. In early life, appropriate intestinal colonization by specific microflora stimulates the maturation of the intestinal mucosa-associated lymphoid tissue. If the appropriate intestinal flora fails to form during this life stage, the function of the intestinal immune system becomes impaired, leading to increased incidence and/or morbidity of certain intestinal diseases, including ulcerative colitis, Crohn¿s disease, and others.

Current pharmacologic therapies for chronic hepatitis B virus (HBV) infection allow viral suppression and normalization of the liver enzyme alanine aminotransferase (ALT) and prevent liver disease from progressing. The currently available antiviral therapies very rarely lead to a functional cure. Thus, the future of a cure for HBV lies in triple combination therapies with concerted action on replication inhibition, antigen reduction, and immune stimulation. This book reviews the mechanisms and pathogenesis of HBV, as well as discusses current and potential future treatments.

Colorectal cancer (CRC) is a major health problem because it represents around 10% of all cancers and achieves a worldwide estimate of 1.4 million newly diagnosed cases annually, resulting in approximately 700,000 deaths. Approximately 19-31% of patients present liver metastases. At diagnosis, a further 23-38% will develop extra-hepatic disease. Over the past decade, the widespread use of modern chemotherapeutic and biological agents, combined with laparoscopic surgical techniques, has improved the prognosis of metastatic CRC. A better understanding of the biology of the tumor, along with high efficiency of diagnostic and therapeutic methods, as well as the spread of screening programs, will improve the survival of the CRC patients in the near future.

The term "ascites" is from the Greek word askites meaning "baglike." Although most commonly due to cirrhosis, severe liver disease or metastatic cancer, its presence can be a sign of other significant medical problems, such as Budd-Chiari syndrome. Diagnosis of the cause is usually done with blood tests, an ultrasound scan of the abdomen, and direct removal of the fluid by a needle or paracentesis (which may also be therapeutic). Treatment using medications (diuretics), external drainage, or other treatments is clearly defined. In this book, the authors describe the physiopathology of the diverse causes of ascites,the types of treatments recommended, the recent advances achieved, the complications and the prognosis of the different clinical situations that doctors must face.

Pancreatitis may be acute or chronic. Although they can be caused by similar aetiologies, they tend to follow distinct natural histories. Around 80% of acute pancreatitis (AP) diagnoses occur as secondary to gallstone disease and alcohol misuse. This disease is commonly associated with the sudden onset of upper abdominal that is usually severe enough to warrant the patient seeking urgent medical attention. Overall, 10 to 25% of AP episodes are classified as severe, leading to an associated mortality rate of 7 to 30%. Treatment is conservative and consists of general medical support performed by experienced teams, sometimes in ICUs. Although most cases of acute pancreatitis are uncomplicated and resolve spontaneously, the presence of complications has significant prognostic importance. Necrosis, hemorrhage, and infection convey rates of up to 25%, 50%, and 80% mortality, respectively. Other complications such as pseudocyst formation, pseudoaneurysm formation, or venous thrombosis increase morbidity and mortality to a lesser degree. The presence of pancreatic infection must be avoided.

Human helminthiasis, known as worm infections, is any macroparasitic disease affecting humans, in which a part of the body is invaded by a lot of worms, known as helminths. They are broadly classified into flukes, tapeworms, and roundworms. Soil-transmitted helminthiasis and schistosomiasis are the most important, being included into the neglected tropical diseases. Helminthiasis has been found to result in poor birth outcome, less cognitive development, lower school and work performance, lower socioeconomic development, and poverty. Soil-transmitted helminthiases are responsible for parasitic infections in as much as a quarter of the human population worldwide. This group of infective diseases has been targeted under the joint action of the world's leading pharmaceutical companies and local governments, trying to achieve their eradication.

Acute Pancreatitis (AP) in approximately 80% of cases, occurs as a secondary complication related to gallstone disease and alcohol misuse. However there are several other different causes that produce it such as metabolism, genetics, autoimmunity, post-ERCP, and trauma for example... This disease is commonly associated with the sudden onset of upper abdominal pain that is usually severe enough to warrant the patient seeking urgent medical attention. Overall, 10-25% of AP episodes are classified as severe. This leads to an associated mortality rate of 7-30% that has not changed in recent years. Treatment is conservative and generally performed by experienced teams often in ICUs. Although most cases of acute pancreatitis are uncomplicated and resolve spontaneously, the presence of complications has a significant prognostic importance. Necrosis, hemorrhage, and infection convey up to 25%, 50%, and 80% mortality, respectively. Other complications such as pseudocyst formation, pseudo-aneurysm formation, or venous thrombosis, increase morbidity and mortality to a lesser degree. The presence of pancreatic infection must be avoided.