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Pathogenesis and clinical management of Helicobacter pylori gastric infection

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World Journal of Gastroenterology 2019年第37期25卷 5578-5589页

作者： Breno Bittencourt de Brito filipe Ant?nio Fran?a da Silva Aline Silva Soares vinícius Afonso Pereira Maria Luísa Cordeiro Santos Mariana Miranda Sampaio Pedro Henrique Moreira Neves Fabrício Freire de Melo Instituto Multidisciplinar em Saúde Universidade Federal da Bahia

Helicobacter pylori(***)is a gram-negative bacterium that infects approximately 4.4 billion individuals ***,its prevalence varies among different geographic areas,and is influenced by several *** infection can be acquired by means of oral-oral or fecal-oral transmission,and the pathogen possesses various mechanisms that improve its capacity of mobility,adherence and manipulation of the gastric microenvironment,making possible the colonization of an organ with a highly acidic *** addition,*** presents a large variety of virulence factors that improve its pathogenicity,of which we highlight cytotoxin associated antigen A,vacuolating cytotoxin,duodenal ulcer promoting gene A protein,outer inflammatory protein and gamma-glutamyl *** host immune system,mainly by means of a Th1-polarized response,also plays a crucial role in the infection *** most ***-positive individuals remain asymptomatic,the infection predisposes the development of various clinical conditions as peptic ulcers,gastric adenocarcinomas and mucosa-associated lymphoid tissue *** and non-invasive diagnostic methods,each of them with their related advantages and limitations,have been applied in *** ***,bacterial resistance to antimicrobial therapy is a major challenge in the treatment of this infection,and new therapy alternatives are being tested to improve *** *** but not least,the development of effective vaccines against *** infection have been the aim of several research studies.

关键词： Helicobacter pylori virulence factors Immune response Antibiotics vaccines

Maternal low protein diet induces persistent expression changes in metabolic genes in male rats

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World Journal of Diabetes 2020年第5期11卷 182-192页

作者： Allan de Oliveira Lira JoséLuiz de Brito Alves Mariana Pinheiro Fernandes Diogo vasconcelos David filipe Santana João Henrique da Costa-Silva Béatrice Morio Carol Góis Leandro Luciano Pirola Department of Nutrition Federal University of PernambucoVitoria de Santo AntãoPernambuco 55608680Brazil Department of Nutrition Federal University of ParaíbaJoao Pessoa 74556060Brazil Henrique da Costa-Silva Luciano PirolaDepartment of Physical Education and Sport SciencesFederal University of PernambucoVitoria de Santo AntãoPernambuco 55608680Brazil Carmen(Cardiology Metabolism and Nutrition)LaboratoryINSERM U1060Lyon-1 UniversitySouth Lyon Medical FacultyPierre Benite 69310France

BACKGROUND Perinatal exposure to a poor nutritional environment predisposes the progeny to the development of metabolic disease at the adult age,both in experimental models and *** adaptive responses to maternal protein restriction have been reported in metabolic ***,the expression of glucose/fatty acid metabolism-related genes in adipose tissue and liver needs to be *** To evaluate the metabolic impact of perinatal malnutrition,we determined malnutrition-associated gene expression alterations in liver and adipose *** In the present study,we evaluated the alterations in gene expression of glycolytic/Krebs cycle genes(Pyruvate dehydrogenase kinase 4 and citrate synthase),adipogenic and lipolytic genes and leptin in the adipose tissue of offspring rats at 30 d and 90 d of age exposed to maternal isocaloric low protein(LP)diet throughout gestation and *** also evaluated,in the livers of the same animals,the same set of genes as well as the gene expression of the transcription factors peroxisome proliferator-activated receptor gamma coactivator 1,forkhead box protein O1 and hepatocyte nuclear factor 4 and of gluconeogenic *** In the adipose tissue,we observed a transitory(i.e.,at 30 d)downregulation of pyruvate dehydrogenase kinase 4,citrate synthase and carnitine palmitoyl transferase 1b gene *** transcriptional changes did not persist in adult LP rats(90 d),but we observed a tendency towards a decreased gene expression of leptin(P=0.052).The liver featured some gene expression alterations comparable to the adipose tissue,such as pyruvate dehydrogenase kinase 4 downregulation at 30 d and displayed other tissue-specific changes,including citrate synthase and fatty acid synthase upregulation,but pyruvate kinase downregulation at 30 d in the LP group and carnitine palmitoyl transferase 1b downregulation at 90 *** gene alterations,together with previously described changes in gene expression in

关键词： Metabolic adaptation Phenotype plasticity Liver Adipose tissue Metabolism Maternal protein undernutrition Rats

Extensive right coronary artery thrombosis in a patient with COvID-19:A case report

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World Journal of Clinical Cases 2022年第31期10卷 11508-11516页

作者： Clarissa Campo Dall’Orto Rubens Pierry ferreira Lopes Mariana Torres Cancela Ciria de Sales Padilha Gilvan vilella Pinto Filho Marcos Raphael da Silva Therapy Center Brazilian Society of Health Support HospitalTeixeira de Freitas 45987-088BahiaBrazil Department of Cardiology Deputy Luis Eduardo Magalhães HospitalPorto Seguro 45810-000BahiaBrazil Intensive Care Unit Medical Assistance Extreme South HospitalEunápolis 45820-131BahiaBrazil

BACKGROUND Occurring in approximately 30%of hospitalized patients,cardiovascular complications that take place during the course of coronavirus disease 2019(COvID-19)have been shown to cause morbidity and *** case is the first report of extensive right coronary artery(RCA)thrombosis that was evaluated by intracoronary imaging and intracoronary invasive physiology in a patient with *** SUMMARY A 62-year-old woman presented with flu-like symptoms;ten days later,she presented with inferior ST-segment elevations,chest pain,dyspnea,nausea and *** patient was diagnosed with COvID-19 following a positive test *** angiography of the RCA and its branches indicated intraluminal filling defects,suggesting a *** ultrasound confirmed a subacute thrombus in the RCA,the right posterior descending branch and the right posterior ventricular(RPv)*** was also an acute thrombus in the RPv branch and atherosclerosis in the *** antiplatelet/anticoagulation therapy was *** 7 d,angiography revealed complete disappearance of the *** coherence tomography confirmed this with the exception of a small thrombus in the RPv branch and atherosclerotic plaque in the *** atherosclerotic RCA was measured using the resting fullcycle ratio,indicating no impairment to coronary *** patient was discharged on the 11^(th) day of hospitalization and remained asymptomatic through the 6-mo *** This was the first report of RCA thrombosis in a patient with *** antiplatelet/anticoagulation therapy was successful.

关键词： Acute coronary syndrome Coronary angiography COvID-19,Intravascular ultrasound Thrombosis Case report

Rupture of a hepatic adenoma in a young woman after an abdominal trauma: A case report

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World Journal of Gastroenterology 2013年第27期19卷 4422-4426页

作者： Ricardo Lemos Cotta-Pereira Luana ferreira valente Daniela Goncalves De Paula Antnio Luís Eiras-Araújo Antnio Carlos Iglesias Department of Surgery Federal University of Rio De Janeiro State (UNIRIO) Department of Surgery Militar Police Hospital (HPMRJ) Rio de Janeiro Department of Radiology Federal University of Rio de Janeiro (UFRJ) and Instituto D'Or

Unlike hepatic haemorrhage following blunt abdominal trauma, spontaneous abdomen bleeding is rare, even in the presence of a hepatocellular adenoma (HA) or carcinoma. However, the diagnosis of a tumour underlying a haematoma after liver trauma is unusual, especially when it occurs more after two years after the accident. Here, we report a case of a ruptured HA due to blunt abdominal trauma. A 36-year-old woman was admitted to our hospital with sudden onset of upper abdominal pain. Her medical history revealed a blunt abdominal trauma two years prior. Initial abdominal computed tomography scan revealed a large haematoma measuring more than 16 cm in diameter in the right lobe of the liver. Magnetic resonance imaging showed haemorrhagic areas and some regions with hepatocyte hyperplasia, suggesting HA. The patient underwent right hepatic lobectomy, and a histopathological examination confirmed a diagnosis of HA. In conclusion, it is important to consider that abdominal trauma may hide old, asymptomatic and not previously detected injuries, as in the case reported.

关键词： Hepatic adenoma Treatment Hemoperitoneum Trauma Computed tomography

Distance Interventions for Children with Sleep Problems: A Review

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Journal of Psychological Research 2022年第1期4卷 18-26页

作者： Tatiana Matheus Pinto Jéssica de Assis da Silva Renatha El Rafihi-ferreira Edwiges ferreira de Mattos Silvares Social and Cognitive Laboratory and Developmental Disorders Program Center for Health and Biological SciencesMackenzie Presbyterian UniversitySao PauloBrazil Ninth of July University Sao PauloBrazil Sleep Outpatient Clinic of Psychiatry Institute Clinics Hospital of Sao Paulo Medicine FacultySao PauloBrazil Department of Psychology Institute of PsychologyUniversity of Sao PauloBrazil

Sleep problems in childhood are frequent and may cause damage to the children and their families;however,parental orientation appears to be effective in its many new formats,such as the distance *** study aimed to review the literature about behavioral intervention performed by distance to sleep problems in childhood and summarize the main characteristics of such *** were performed up to November 2021 in BvS Psicologia ULAPSI Brasil,SCOPUS,and PsycINFO,using the key words:sleep problems,insomnia,nighttime fears,behavioral intervention,behavioral treatment,treatment,intervention,sleep,behavior,child,children,infant,mobile phones,smartphone,app,telephone,online,internet,*** included 14 *** main results indicate that interventions were implemented between 2 and 12 weeks,the most reported procedure was pre-sleep routines,and semi-presential interventions that required some presential contact were the most *** educational information about sleep through bibliotherapy and telephone contacts were the most used tools to implement the remote component of *** studies indicated improvements on children’s sleep,and secondary results(parental sleep and/or mental health)were also reported among ***,our findings suggest that distance interventions for childhood sleep problems are promising,but future research is still needed.

关键词： Sleep problems Distance intervention Children Review

Tertiary peritonitis: A disease that should not be ignored

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World Journal of Clinical Cases 2021年第10期9卷 2160-2169页

作者： Hanna Santos Marques Glauber Rocha Lima Araújo filipe Antônio França da Silva Breno Bittencourt de Brito Paulo victor Dias versiani Jaqueline Silva Caires Thiago de Carvalho Milet Fabrício Freire de Melo Campus vitória da Conquista Universidade Estadual do Sudoeste da BahiaVitória da Conquista 45083-900BahiaBrazil Instituto Multidisciplinar em Saúde Universidade Federal da BahiaVitória da Conquista 45029-094BahiaBrazil Department of Surgery Hospital Geral de Vitória da ConquistaVitória da Conquista 45029-094BahiaBrazil

Intra-abdominal infections can be classified into uncomplicated or complicated(peritonitis). Peritonitis is divided into primary, secondary, and tertiary. Tertiaryperitonitis is the less common but the most severe among peritonitisstratifications, being defined as a recurrent intra-abdominal infection that occurs48 h after a well-succeeded control of a secondary peritonitis. This disease has acomplex pathogenesis that is closely related to the capacity of the peritonealcavity to activate immunological processes. Patients who progress to persistentperitonitis are at an increased risk of developing several infectious complicationssuch as sepsis and multiple organ failure syndrome. Moreover, tertiary peritonitisremains an important cause of hospital death mainly among patients withassociated risk factors. The microbiological profile of organisms causing tertiaryperitonitis is often different from that observed in other types of peritonitis. Inaddition, there is a high prevalence of multidrug-resistant pathogens causing thiscondition, and an appropriate and successful clinical management depends on anearly diagnosis, which can be made easier with the use of clinical scorespresenting a good prediction value during the intensive care unit ***, immediate therapy should be performed to control theinfectious focus and to prevent new recurrences. In this sense, the treatment isbased on initial antimicrobial therapy and well-performed peritoneal drainage.

关键词： Tertiary peritonitis Pathogenesis Clinical manifestation Diagnosis Treatment Prognosis

Peroxisome proliferator-activated receptor-alpha activation and dipeptidyl peptidase-4 inhibition target dysbiosis to treat fatty liver in obese mice

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World Journal of Gastroenterology 2022年第17期28卷 1814-1829页

作者： Flavia Maria Silva-veiga Carolline Santos Miranda Isabela Macedo Lopes vasques-Monteiro Henrique Souza-Tavares Fabiane ferreira Martins Julio Beltrame Daleprane vanessa Souza-Mello Department of Anatomy Institute of BiologyState University of Rio de JaneiroLaboratory of MorphometryMetabolism and Cardiovascular DiseasesRio de Janeiro 20551-030Brazil Department of Clinical and Toxicology Analysis State University of Rio de JaneiroNutrition InstituteState University of Rio de JaneiroNutrition InstituteUniversity of Sao PauloRio de Janeiro 20551-030Brazil

BACKGROUND Obesity and comorbidities onset encompass gut dysbiosis,altered intestinal permeability,and *** that target gut dysbiosis can cope with obesity and nonalcoholic fatty liver disease(NAFLD)*** proliferator-activated receptor(PPAR)-alpha activation and dipeptidyl-peptidase-4(DPP-4)inhibition alleviate NAFLD,but the mechanism may involve gut microbiota modulation and merits further *** To address the effects of PPAR-alpha activation and DPP-4 inhibition(isolated or combined)upon the gut-liver axis,emphasizing inflammatory pathways in NAFLD management in high-fat-fed C57BL/6J *** Male C57BL/6J mice were fed a control diet(C,10%of energy as lipids)or a highfat diet(HFD,50%of energy as lipids)for 12 wk,when treatments started,forming the groups:C,HF,HFA(HFD+PPAR-alpha agonist WY14643,2.5 mg/kg body mass),HFL(HFD+DPP-4 inhibitor linagliptin,15 mg/kg body mass),and HFC(HFD+the combination of WY14643 and linagliptin).RESULTS The HFD was obesogenic compared to the C *** treatments elicited significant body mass loss,and the HFC group showed similar body mass to the C *** treatments tackled oral glucose intolerance and raised plasma glucagon-like peptide-1 *** metabolic benefits restored Bacteroidetes/Firmicutes ratio,resulting in increased goblet cells per area of the large intestine and reduced lipopolysaccharides concentrations in treated *** the gene level,treated groups showed higher intestinal Mucin 2,Occludin,and Zo-1 expression than the HFD *** reduced endotoxemia suppressed inflammasome and macrophage gene expression in the liver of treated *** observations complied with the mitigation of liver steatosis and reduced hepatic triacylglycerol,reassuring the role of the proposed treatments on NAFLD *** PPAR alpha activation and DPP-4 inhibition(isolated or combined)tackled NAFLD in dietinduced obese mice by restoration of gut-liver axis

关键词： Nonalcoholic fatty liver disease High-fat diet Peroxisome proliferator-activated receptor-alpha Dipeptidyl-peptidase-4-inhibitor Dysbiosis Inflammation

Interferon-β induced in female genital epithelium by HIv-1 glycoprotein 120 via Toll-like-receptor 2 pathway acts to protect the mucosal barrier

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Cellular & Molecular Immunology 2019年第2期16卷 178-194页

作者： Aisha Nazli Sara Dizzell Muhammad Atif Zahoor victor H ferreira Jessica Kafka Matthew William Woods Michel Ouellet Ali A Ashkar Michel J Tremblay Dawn ME Bowdish Charu Kaushic McMaster Immunology Research Centre Michael G.DeGroote Center for Learning and DiscoveryMcMaster UniversityHamiltonON L8S 4K1Canada Department of Pathology and Molecular Medicine McMaster UniversityHamiltonON L8S 4K1Canada Department of Medical Biology Laval UniversityQuebec CityQC G1V 0A6Canada

More than 40%of HIv infections occur via female reproductive tract(FRT)through heterosexual *** cells that line the female genital mucosa are the first line of defense against HIv-1 and other sexually transmitted *** sentient cells recognize and respond to external stimuli by induction of a range of carefully balanced innate immune ***,we have shown that in response to HIv-1 gp120,the genital epithelial cells(GECs)from upper reproductive tract induce an inflammatory response that may facilitate HIv-1 translocation and *** this study,we report that the endometrial and endocervical GECs simultaneously induce biologically active interferon-β(IFNβ)antiviral responses following exposure to HIv-1 that act to protect the epithelial tight junction *** innate antiviral response was directly induced by HIv-1 envelope glycoprotein gp120 and addition of gp120 neutralizing antibody inhibited IFNβ***-βwas induced by gp120 in upper GECs through Toll-like receptor 2 signaling and required presence of heparan sulfate on epithelial cell *** induction of IFNβwas dependent upon activation of transcription factor IRF3(interferon regulatory factor 3).The IFNβwas biologically active,had a protective effect on epithelial tight junction barrier and was able to inhibit HIv-1 infection in TZM-bl indicator cells and HIv-1 replication in T *** is the first report that recognition of HIv-1 by upper GECs leads to induction of innate antiviral *** could explain the overall low infectivity of HIv-1 in the FRT and could be exploited for HIv-1 prophylaxis.

关键词： antiviral response genital epithelium HIv-1 IFN-β innate immunity IRF-3 mucosal barrier TLR2

Managing gastroesophageal reflux disease in children: The role of endoscopy

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World Journal of Gastrointestinal Endoscopy 2012年第8期4卷 339-346页

作者： Helena AS Goldani Daltro LA Nunes Cristina T ferreira Department of Pediatrics and Gastroenterology Unit Hospital de Clinicas de Porto Alegre Faculdade de Medicina da Universidade Federal do Rio Grande do Sul 90035-903 Porto Alegre-RS Brazil

Gastroesophageal reflux disease (GERD) is a growing problem in the pediatric population and recent advances in diagnostics and therapeutics have improved their management, particularly the use of esophago-gastroduodenoscopy (EGD). Most of the current knowledge is derived from studies in adults; however there are distinct features between infant onset and adult onset GERD. Children are not just little adults and attention must be given to the stages of growth and development and how these stages impact the disease management. Although there is a lack of a gold standard test to diagnose GERD in children, EGD with biopsy is essential to assess the type and severity of tissue damage. To date, the role of endoscopy in adults and children has been to assess the extent of esophagitis and detect metaplastic changes complicating GERD; however the current knowledge points another role for the EGD with biopsy that is to rule out other potential causes of esophagitis in patients with GERD symptoms such as eosinophilic esophagitis. This review highlights special considerations about the role of EGD in the management of children with GERD.

关键词： Endoscopy Gastroesophageal reflux Esophagitis Infants Children