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Noninvasive diagnosis of periportal fibrosis in schistosomiasis mansoni:A comprehensive review

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World Journal of Hepatology 2022年第4期14卷 696-707页

作者： Joelma Carvalho Santos Caroline Louise Diniz Pereira Ana Lúcia Coutinho Domingues edmundo pessoa lopes Postgraduate Program in Tropical Medicine Center of Health SciencesUniversidade Federal de PernambucoRecife 50670-901PernambucoBrazil Gastroenterology Division Department of Internal Medicine of Center of Health SciencesHospital das Clínicas-Universidade Federal de PernambucoRecife 50670-901PernambucoBrazil

Schistosomiasis mansoni is a neglected disease and key public health problem,mainly due to its high prevalence,the scarcity of public policies,and the severity of some clinical *** fibrosis(PPF)is the commonest complication of chronic schistosomiasis mansoni and its diagnosis requires different *** though wedge biopsy of the liver is considered the gold standard,it is not justified in non-surgical patients,and percutaneous liver biopsy may be informative but does not have sufficient *** PPF tests mostly include biological(serum biomarkers or combined scores)or physical assessments(imaging assessment of fibrosis pattern or tissue stiffness).Moreover,imaging techniques,such as ultrasound,computed tomography,magnetic resonance imaging,and elastography are applied not only to support the diagnosis of schistosomiasis,but also to assess and detect signs of portal hypertension and organ damage due to chronic schistosomiasis.A combination between a comprehensive history and physical examination with biomarkers for liver fibrosis and imaging methods seems to offer the best approach for evaluating these *** addition,understanding their strengths and limitations will allow a more accurate interpretation in the clinical context and can lead to greater accuracy in estimating the degree of fibrosis in patients with Schistosomiasis mansoni(***)*** review will discuss the different noninvasive methods that are currently available for the evaluation of PPF in *** infection,and their application,advantages,and limitations in clinical practice.

关键词： Schistosoma mansoni Parasitic liver diseases Liver fibrosis Biomarkers Elasticity imaging techniques Ultrasonography

High prevalence of occult hepatitis C infection in predialysis patients

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World Journal of Hepatology 2019年第1期11卷 109-118页

作者： Luís Henrique Bezerra Cavalcanti Sette edmundo pessoa de Almeida lopes Nathália Campello Guedes dos Anjos Lucila Maria Valente Sávio Augusto Vieira de Oliveira Norma Lucena-Silva Nephrology-Department of Clinical Medicine Federal University of Pernambuco Gastroenterology-Department of Clinical Medicine Federal University of Pernambuco Laboratory of Immunogenetics of the Aggeu Magalh?es Institute - Fiocruz Pernambuco

BACKGROUND Occult hepatitis C virus(HCV) infection(OCI) may be associated with extrahepatic diseases and it is known that the patients with chronic kidney disease(CKD) who are on hemodialysis(HD) present a higher prevalence of this type of infection than the general population, with a worse clinical ***, there are no data in the literature to assess the presence of OCI in patients prior to the initiation of renal replacement therapy(RRT). Therefore, this study aimed to evaluate the occurrence and epidemiological aspects of OCI in patients with Predialysis CKD. We hypothesize that this infection could occur before RRT *** To research the status in predialysis patients when HD patients have high prevalence of *** A cross-sectional study was conducted between 2015 and 2017. Adults with creatinine clearance < 60 mL/min·1.73 m^2(predialysis patients) were recruited to the study. Pregnant and postpartum women, patients with glomerulopathies,and patients showing positivity for serological markers of hepatitis B virus(HBV), HCV or human immunodeficiency virus infection were excluded. Patients were diagnosed with OCI according to test results of anti-HCV antibody negativity and HCV RNA positivity in either ultracentrifuged serum or, if serumnegative, in peripheral blood mononuclear *** Among the 91 total patients included in the study, the prevalence of OCI was 16.5%. Among these 15 total OCI patients, 1 was diagnosed by 14 ultracentrifuged serum results and 14 were diagnosed by peripheral blood mononuclear cell results. Compared to the non-OCI group, the OCI patients presented higher frequency of older age(P = 0.002), patients with CKD of mixed etiology(P = 0.019), and patients with markers of previous HBV infection(i.e.,combined positivity for anti-hepatitis B core protein antibody and anti-hepatitis B surface protein antibody)(P = 0.001).CONCLUSION Among predialysis patients, OCI involved the elderly, patients with CKD of mixed eti

关键词： Occult hepatitis infection Chronic hepatitis C Chronic kidney disease Hemodialysis Hepatitis C virus-RNA Peripheral blood mononuclear cells

Assessment of periportal fibrosis in Schistosomiasis mansoni patients by proton nuclear magnetic resonance-based metabonomics models

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World Journal of Hepatology 2022年第4期14卷 719-728页

作者： Milena Lima Rodrigues Tatiane Priscila Santos Rodrigues da Luz Caroline Louise Diniz Pereira Andrea Dória Batista Ana Lúcia Coutinho Domingues Ricardo Oliveira Silva edmundo pessoa lopes Programa de Pós-Graduação em Medicina Tropical Centro de Ciências MédicasUniversidade Federal de PernambucoRecife 50670-901PernambucoBrazil Programa de Pós-Graduação em Química Centro de Ciências Exatas e da NaturezaUniversidade Federal de PernambucoRecife 50670-740PernambucoBrazil Hospital das Clínicas Departamento de Medicina ClínicaUniversidade Federal de PernambucoRecife 50670-901PernambucoBrazil

BACKGROUND The evaluation of periportal fibrosis(PPF)is essential for a prognostic assessment of patients with Schistosomiasis *** WHO Niamey Protocol defines patterns of fibrosis from abdominal ultrasonography,^(1)H-nuclear magnetic resonance(NMR)-based metabonomics has been employed to assess liver fibrosis in some *** To build 1H-NMR-based metabonomics models(MM)to discriminate mild from significant periportal PPF and identify differences in the metabolite *** A prospective cross-sectional study was performed on schistosomiasis patients at a University Hospital in Northeastern *** evaluated 41 serum samples from 10 patients with mild PPF(C Niamey pattern)and 31 patients with significant PPF(D/E/F Niamey patterns).MM were built using partial least squares-discriminant analysis(PLS-DA)and orthogonal projections to latent structures discriminant analysis(OPLS-DA)*** PLS-DA and OPLS-DA resulted in discrimination between mild and significant PPF groups with R2 and Q2 values of 0.80 and 0.38 and 0.72 and 0.42 for each model,*** OPLS-DA model presented accuracy,sensitivity,and specificity values of 92.7%,90.3%,and 100%to discriminate significant *** metabolites identified as responsible by discrimination were:Nacetylglucosamines,alanine,glycolaldehyde,carbohydrates,and *** MMs discriminated mild from significant PPF patterns in patients with Schistosomiasis mansoni through identification of differences in serum metabolites profiles.

关键词： Metabolomics Portal hypertension Schistosoma mansoni Biomarkers Neglected disease Nuclear magnetic resonance

Proton nuclear magnetic resonance-based metabonomic models for non-invasive diagnosis of liver fibrosis in chronic hepatitis C:Optimizing the classification of intermediate fibrosis

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World Journal of Hepatology 2018年第1期10卷 105-115页

作者： Andrea Dória Batista Carlos Jonnatan Pimentel Barros Tássia Brena Barroso Carneiro Costa Michele Maria Goncalves de Godoy Ronaldo Dionísio Silva Joelma Carvalho Santos Mariana Montenegro de Melo Lira Norma ThoméJucá edmundo pessoa de Almeida lopes Ricardo Oliveira Silva Postgraduate Program in Tropical Medicine Center for Health SciencesUniversidade Federal de PernambucoRecifePernambuco 50670-901Brazil Department of Gastroenterology and Hepatology Hospital das ClínicasUniversidade Federal de PernambucoRecifePernambuco 50670-901Brazil Department of Fundamental Chemistry Center for Exact and Nature SciencesUniversidade Federal de PernambucoRecifePernambuco 50670-901Brazil Intensive Care Unit Hospital das ClínicasUniversidade Federal de PernambucoRecifePernambuco 50670-901Brazil Department of Pathology Hospital das ClínicasUniversidade Federal de PernambucoRecifePernambuco 50670-901Brazi

AIM To develop metabonomic models(MMs), using 1 H nuclear magnetic resonance(NMR) spectra of serum, to predict significant liver fibrosis(SF: Metavir ≥ F2), advanced liver fibrosis(AF: METAVIR ≥ F3) and cirrhosis(C: METAVIR = F4 or clinical cirrhosis) in chronic hepatitis C(CHC) patients. Additionally, to compare the accuracy of the MMs with the aspartate aminotransferase to platelet ratio index(APRI) and fibrosis index based on four factors(FIB-4). METHODS Sixty-nine patients who had undergone biopsy in the previous 12 mo or had clinical cirrhosis were included. The presence of any other liver disease was a criterion for exclusion. The MMs, constructed using partial least squares discriminant analysis and linear discriminant analysis formalisms, were tested by cross-validation, considering SF, AF and C. RESULTS Results showed that forty-two patients(61%) presented SF, 28(40%) AF and 18(26%) C. The MMs showed sensitivity and specificity of 97.6% and 92.6% to predict SF; 96.4% and 95.1% to predict AF; and 100% and 98.0% to predict C. Besides that, the MMs correctly classified all 27(39.7%) and 25(38.8%) patients with intermediate values of APRI and FIB-4, respectively. CONCLUSION The metabonomic strategy performed excellently in predicting significant and advanced liver fibrosis in CHC patients, including those in the gray zone of APRI and FIB-4, which may contribute to reducing the need for these patients to undergo liver biopsy.

关键词： Metabolomics Nuclear magnetic resonance spectroscopy Chronic hepatitis C Liver fibrosis Surrogate markers

Immediate bail-out TAP-stenting for the treatment of iatrogenic aortocoronary dissection involving left main bifurcation

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Journal of Geriatric Cardiology 2013年第2期10卷 202-204页

作者： edmundo Patricio lopes Lao Shao-Ping Nie Chang-Sheng Ma Department of Cardiology Beijing Anzhen Hospital Capital Medical University Beijing 100029 China

Iatrogenic aortocoronary dissection is a rare but potentially disastrous complication of percutaneous coronary intervention. The left main dissection extending into distal bifurcation involving both the left anterior descending and left circumflex is a complex and vital complication, which is classified as Eshtehardi Type II dissection. We presented a case of iatrogenic left main coronary artery dissection with upcoming closure of both major branches, which was successfully managed by immediate bail-out TAP-stenting. The 77-year-old patient was discharged without any complication, and 1-year follow-up indicated stent patency and favorable clinical result. Immediate bail-out stenting is a feasible and reasonable initial management for this lethal complication.

关键词： Aorta Bail-out stenting Coronary artery Dissection Percutaneous coronary intervention

Trans-brachial artery access for coronary artery procedures is feasible and safe: data from a single-center in Macao

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Chinese Medical Journal 2019年第12期132卷 1478-1481页

作者： U Po Lam edmundo Patricio lopes Lao Kan Chit Lam Mario Evora Na-Qiong Wu Department of Cardiology Centro Hospital Conde de Sao JanuarioMacaoChina University of Michigan Ann ArborMichigan 48104USA Department of Cardiology Center of Endocrinology & CardiometabolismNational Center for Cardiovascular DiseasesFuwai HospitalBeijing 100037China

Compared with trans-femoral artery access (TFA), trans-radial artery access (TRA) for percutaneous coronary interventions (PCI) has been shown to significantly reduce 30-day mortality, in-hospital major adverse cardiac and cardiovascular events (a composite of 30-day mortality and in-hospital myocardial re-infarction, target vessel revascularization, and cerebrovascular events), major bleeding, and access site complications.[1] TRA is more easily compressible, minimizing hematoma risk, and lower crossover rates to another access. Patients may ambulate immediately after procedure, that hospitalization can be shortened significantly. In some centers, patient with TRA can be discharged on the same day of procedure. It is also superior to TFA with closure devices, and becomes the preferred access site for recent PCI.[2]

关键词： Trans-brachial artery access coronary artery procedures

Recurrent Cardiac Tamponade from Right Atrial Angiosarcoma

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Chinese Medical Journal 2018年第11期131卷 1379-1380页

作者： Na-Qiong Wu edmundo Patricio lopes Lao U Po Lain Yuk Ching Yip Mario Evora Division of Dyslipidemia State Key Laboratory of Cardiovascular Disease FuWai Hospital National Center for Cardiovascular Diseases Chinese Academy of Medical Sciences Peking Union Medical College Beijing 100037 China Department of Cardiology Centro Hospitalar Conde de Sao Januario Macao China Department of Pathology Kiang Wu Hospital Macao China

To the Editor： A 70-year-old Chinese gentleman with end-stage renal disease on intermittent peritoneal dialysis （IPD） was admitted to nephrology ward for regular IPD therapy in August 2016. After admission, he presented sudden lower back pain with significant anemia. Computed tomography （CT） scan showed large amount of pericardial effusion, bilateral pleural effusion, and ascites in abdomen and pelvis. Later on, he was intubated with mechanical ventilation support and on continuous venovenous hemofiltration. Pericardiocentesis and thoracocentesis were performed. On the 9＂ day of admission.

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Very late thrombosis 12 years after bare metal stent deployment

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Chinese Medical Journal 2014年第6期127卷 1183-1184页

作者： Wang Jihong Qiao Yan Zhang Yin edmundo Patricio lopes Lao Salim Mohamed Ma Changsheng Wu Xuesi Department of Cardiology Beijing Anzhen Hospital Capital Medical University Beijing 100029 China

Percutaneous coronary intervention(PCI)is currentlythe most commonly used revascularization techniquein the management of symptomatic coronary ***,late stent thrombosis(LST)and in-stent

关键词： angina bare metal stent very late thrombosis neointimal atherosclerotic

Provisioning of Inter-Domain QoS-Aware Services

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Journal of Computer Science & Technology 2015年第2期30卷 404-420页

作者： Fernando Matos Alexandre Matos Paulo Simoes edmundo Monteiro Department of Computer Systems Federal University of Paraba Jodo Pessoa 58051-900 Brazil Department of Information Systems State University of Santa Catarina Sao Bento do Sul 89283-081 Brazil Department of Informatics Engineering University of Coimbra Coimbra 3030-290 Portugal Centre for Informatics and Systems University of Coimbra Coimbra 3030-290 Portugal

Cooperation among service providers, network providers, and access providers in the Internet allows the creation of new services to offer to customers that are in other domains, thus increasing revenue. However, the Internet heterogeneous environment, where each provider has its own policies, infrastructure and business goals, hinders the deployment of more advanced communication services. This paper presents a Quality of Service （QoS） for Inter-Domain Services （QIDS） model that allows inter-domain QoS-aware services to be defined, configured, and adapted in a dynamic and on-demand fashion, among service providers. This is accomplished by： 1） the use of a common communication channel （business layer） where service providers publish and search for services, and interact with each other to contract and manage these services; 2） the templates to specify the business and technical characteristics of the services; 3） the automatic composition of services using service dements （smaller services） a^cording to performance and service-specific QoS parameters; and 4） the creation and enforcement of configuration rules for the underlying infrastructure. A prototype was implemented to validate QIDS and performance tests were conducted on an inter-domain Border Gateway Protocol （BGP）/Multiprotocol Label Switching （MPLS） Virtual Private Network （VPN） scenario.

关键词： service provisioning inter-domain QoS service composition