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Immune response to helicobacter pylori infection and gastric cancer development

World Journal of Meta-Analysis 2021年第3期9卷 257-276页

作者： Breno Bittencourt de Brito Fabian Fellipe Bueno Lemos Caroline da Mota Carneiro Andressa Santos Viana Nilo Manoel Pereira Vieira Barreto gabriela alves de Souza Assis Barbara Dicarlo Costa Braga Maria Luísa Cordeiro Santos Filipe Antônio França da Silva hanna Santos Marques Natália Oliveira e Silva Fabrício Freire de Melo Instituto Multidisciplinar em Saúde Universidade Federal da BahiaVitória da Conquista 45029-094BahiaBrazil Campus Vitória da Conquista Universidade Estadual do Sudoeste da BahiaVitória da Conquista 45031900BahiaBrazil

Gastric adenocarcinoma is a global health concern,and helicobacter pylori(***)infection is the main risk factor for its *** note,the immune response against the pathogen seems to be a determining factor for gastric oncogenesis,and increasing evidence have emphasized several host and bacterium factors that probably influence in this *** development of an inflammatory process against *** involves a wide range of mechanisms such as the activation of pattern recognition receptors and intracellular pathways resulting in the production of proinflammatory cytokines by gastric epithelial *** process culminates in the establishment of distinct immune response profiles that result from the cytokine-induced differentiation of T naïve cells into specific T helper *** released from each type of T helper cell orchestrate the immune system and interfere in the development of gastric cancer in idiosyncratic ***,variants in genes such as single nucleotide polymorphisms have been associated with variable predispositions for the occurrence of gastric malignancy because they influence both the intensity of gene expression and the affinity of the resultant molecule with its *** addition,various repercussions related to some *** virulence factors seem to substantially influence the host immune response against the infection,and many of them have been associated with gastric tumorigenesis.

关键词： Gastric cancer helicobacter pylori Immune response Virulence factors Polymorphisms

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Opportunistic Infections in Late Kidney Transplantation with Death Outcome: Case Report

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Open Journal of Nephrology 2021年第2期11卷 171-182页

作者： Miriam Viviane Baron Carina Marangoni Michele Paula dos Santos Célia Regina Martins Korzenieski Vitória Pereira Itaquy Tais Michele Werle gabriela Di Lorenzo Garcia Scherer Joice Nedel Ott Marcus Vinicius de Mello Pinto Janine Koepp Carolina Gonçalves Pinheiro Nathália Ken Pereira Iketani Cristine Brandenburg Aline Ronis Sampaio Alexandre Sancho Danielle de Mello Florentino Bartira Ercília Pinheiro da Costa Postgraduate Program in Medicine and health Sciences of the Pontifical Catholic University of Rio Grande do Sul (PUC/RS) Porto Alegre Brazil Coordination for the Improvement of higher Education Personnel Brazilia Brazil School of Medicine of the Pontifical Catholic University of Rio Grande do Sul (PUC/RS) Porto Alegre Brazil Schoolof health and Life Sciences of the Pontifical Catholic University of Rio Grande do Sul (PUC/RS) Porto Alegre Brazil CelulareInstitute Rio de Janeiro Brazil University of Santa Cruz do Sul (UNISC) Santa Cruz do Sul Brazil Postgraduate Program in health Sciences of the Faculty of Medicine of ABC (FMABC) S&atilde o Paulo Brazil hospital Beneficiente Portuguesa of Belém Pará Brazil Dom José Institute of Education and Culture/University of Vale do Acaraú (IDJ/UVA) Ceará Brazil Unigranrio University Rio de Janeiro Brazil Uniredentor University Rio de Janeiro Brazil

Cytomegalovirus (CMV) and Pneumocystis jirovecii fungus are the main opportunistic microorganisms that affect transplanted individuals. Immunosuppressive drugs administered to prevent organ rejection leave the immune system vulnerable to these infections. The present report is about a kidney transplanted patient using immunosuppressants who was diagnosed with cytomegalovirus and pneumocystosis requiring admission to the intensive care unit (ICU). Female patient, 57 years old, a kidney transplanted three years ago, with comorbidities, such as systemic arterial hypertension, hypertriglyceridemia and type 2 diabetes mellitus. She was admitted to the hospital in January 2020 with a history of diarrhea, cough, malaise and weight loss of seven kg in a month. She made continuous use of the immunosuppressants tacrolimus® and mycophenolate sodium (MFS). After five days of hospitalization, she was transferred to the ICU due to refractory diarrhea, worsening renal function and respiratory pattern, requiring mechanical ventilation. Chest tomography showed changes that led to the diagnostic hypothesis of CMV pneumonia or Pneumocystis jirovecii. Treatment with Ganciclovir® and Bactrim® was started. The bronchial lavage polymerase chain reaction test confirmed the infectious condition for CMV and Pneumocystis jirovecii. Despite the drug therapy instituted, there was no improvement in the infectious condition. The patient started to present a general and progressive worsening of the clinical picture with loss of renal graft function, respiratory failure, metabolic acidosis, hemodynamic instability and severe distributive shock, evolving to death. In the present report, it was observed that after late kidney transplantation the fragility of the immune system caused by the use of immunosuppressants contributed to the development of a severe infection with CMV and Pneumocystis jirovecii. Adjusting the doses of immunos

关键词： Renal Transplantation Infections Opportunistic Immunosuppressive Agent Cytomegalovirus Pneumocystis

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Pulmonary Tuberculosis Associated with Socioeconomic Vulnerability and Ineffective Support Network: Case Report

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Journal of Biosciences and Medicines 2023年第5期11卷 151-157页

作者： Michele Paula dos Santos gabriela Di Lorenzo Garcia Scherer Carolina hack alves Italo Trois Maestri Carolina Boeira Soares Carlos Augusto Treviso Stella Duarte Pinto Ana Paula Wagner Steinmetz Laura Gomes Boabaid de Barros Maria Eduarda Perobelli Buzetto Gabriel Lorentz Trein Guilherme Boeira Soares Aline Porto Brendda Pereira Gomes Fernanda Bercht Merten Luane Pereira Gomes Bárbara Adelmann de Lima Rafaela Siviero Caron-Lienert Miriam Viviane Baron School of Medicine Pontifical Catholic University of Rio Grande do Sul (PUCRS) Porto Alegre Brazil Course of Medicine Lutheran University of Brazil (ULBRA) Canoas Brazil School of health and Life Sciences Pontifical Catholic University of Rio Grande do Sul (PUCRS) Porto Alegre Brazil Interdisciplinary Institute of Science and health Education Porto Alegre Brazil

Tuberculosis is one of the 10 leading causes of death in the world. Its symptoms include fever, malaise, weakness, weight loss, chest pain, cough, expectoration, shortness of breath and sepsis, which is its most frequent complication. Due to these symptoms, many patients with tuberculosis require admission to the Intensive Care Unit, where they usually are placed on mechanical ventilation. Tuberculosis is more prevalent in the population in situations of social and economic vulnerability. The main factors that interfere with adherence to treatment and the prognosis of these patients are the patient’s support network and their socioeconomic status. We present the following report of a long-time smoker patient, with chronic kidney disease and previous treatment for tuberculosis, who was brought to the emergency room due to lowering of the sensorium, and was immediately placed on mechanical ventilation. The tests suggested sepsis with a respiratory focus, so a search for Alcohol-Acid-Resistant Bacillus was carried out, with a positive result. The patient was transferred to the Intensive Care Unit due to tachycardia and acute respiratory failure. The patient was a smoker with a high tobacco load, chronic kidney disease, in addition to precarious economic, educational and self-care conditions. This report shows that patients with tuberculosis and its complications can be stabilized through known pharmacological treatment. however, the most effective measure to interrupt the transmission of the disease remains the early diagnosis and the provision of adequate treatment, with guidelines aimed at the cessation of harmful habits, such as smoking.

关键词： Smoking Kidney Disease Sepsis Respiratory Failure

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Non-hodgkin’s Lymphoma Associated with Metastatic Lung Cancer: Case Report

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Advances in Lung Cancer 2021年第3期10卷 40-47页

作者： Miriam Viviane Baron gabriela Di Lorenzo Garcia Scherer Célia Regina Martins Korzenieski Julia Braga da Silveira Carolina Boeira Soares Carina Marangoni Marcus Vinicius de Mello Pinto Aline Ronis Sampaio Alexandre Gomes Sancho Esteban Fortuny Pacheco Felice Picariello Joice Nedel Ott Isabel Cristina Reinheimer Carolina Gonçalves Pinheiro Nathália Ken Pereira Iketani Cristine Brandenburg Danielle de Mello Florentino Patrícia Froes Meyer Bartira Ercília Pinheiro da Costa Postgraduate Program in Medicine and health Sciences of the Pontifical Catholic University of Rio Grande do Sul (PUC/RS) Porto Alegre Brazil School of Medicine of the Pontifical Catholic University of Rio Grande do Sul (PUC/RS) Porto Alegre Brazil School of health and Life Sciences of the Pontifical Catholic University of Rio Grande do Sul (PUC/RS) Porto Alegre Brazil Celulare Institute Rio de Janeiro Brazil Unigranrio Rio de Janeiro Brazil Universidad Finis Terrae Santiago Chile Università degli Studi di Napoli Federico II Napoli Italy Postgraduate Program in health Sciences of the Faculty of Medicine of ABC (FMABC) S&#227 o Paulo Brazil hospital Beneficiente Portuguesa of Belém Pará Brazil Federal University of Ceará (UFC) Fortaleza Brazil Uniredentor University Rio de Janeiro Brazil Centro Universitário do Rio Grande do Norte Natal RN Brazil

Lymphomas are neoplastic transformations that affect lymphoid cells. Diffuse large B-cell non-hodgkin’s lymphoma has a high degree of cell proliferation, accounting for 30% of all lymphomas. Lung cancer is the leading cause of death worldwide and the recommended treatment is chemotherapy. Among the main complications resulting from non-hodgkin’s lymphoma, lung cancer and chemotherapy used in their treatment, we can mention sepsis, acute kidney injury and febrile neutropenia. Febrile neutropenia can occur by suppressing the production of neutrophils. Sepsis, a widespread infection, is the main cause of acute kidney injury, which can also be caused by hydroelectrolytic complications or by nephrotoxicity. This is a report of a smoking patient with metastatic lung cancer who sought care due to progressive dysphagia, cough with chest pain, fever, and lower airways critical obstruction due to mediastinal lymphadenopathy, being diagnosed with diffuse large B-cell non-hodgkin’s lymphoma. The patient evolved to death because of a significant worsening of the ventilatory pattern of multifactorial cause, mainly due to sepsis, acute kidney injury, and febrile neutropenia. The patient had mostly classic characteristics of her comorbidities, however, the overlapping of interrelated comorbidities led to the outcome of death. What is unusual about the present case report is that the patient’s characteristics, such as age, sex, and ethnicity, are opposite to those described as risk factors for diffuse large B-cell non-hodgkin’s lymphoma.

关键词： Acute Kidney Injury Febrile Neutropenia Sepsis Chemotherapy

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Early hepatic Encephalopathy after a Transjugular Intrahepatic Portosystemic Shunt Procedure: Case Report

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Open Journal of Gastroenterology 2021年第6期11卷 81-88页

作者： Miriam Viviane Baron gabriela Di Lorenzo Garcia Scherer Michele Paula dos Santos Andres Felipe Mantilla Santamaria Cristine Brandenburg Isabel Cristina Reinheimer Marcus Vinicius de Mello Pinto Aline Ronis Sampaio Alexandre Gomes Sancho Alexandre Gomes Sancho Esteban Fortuny Pacheco Felice Picariello Danielle de Mello Florentino Joice Nedel Ott Carolina Gonçalves Pinheiro Nathália Ken Pereira Iketani Sonia Carvalho Patrícia Froes Meyer Bartira Ercília Pinheiro da Costa Postgraduate Program in Medicine and health Sciences of the Pontifical Catholic University of Rio Grande do Sul (PUC/RS) Porto Alegre Rio Grande do Sul Brazil School of Medicine of the Pontifical Catholic University of Rio Grande do Sul (PUC/RS) Porto Alegre Rio Grande do Sul Brazil Industrial University of Santander (UIS) Bucaramanga Colombia University of Vale do Acaraú (IDJ/UVA) Ceará Brazil Celulare Institute Rio de Janeiro Brazil Unigranrio Rio de Janeiro Brazil Universidad Finis Terrae Santiago Chile Università degli Studi di Napoli Federico II Napoli Italy Uniredentor University Rio de Janeiro Brazil Postgraduate Program in health Sciences of the Faculty of Medicine of ABC (FABC) S&#227o Paulo Brazil hospital Beneficiente Portuguesa of Belém Pará Brazil Rigshospital Copenhagen East K&#248benhavn Denmark Centro Universitário do Rio Grande do Norte Natal Brazil

Patients with decompensated hepatic cirrhosis may present systemic alterations and dysfunction of multiple organs. Ascites, portal hypertension, esophageal varices, and hepatic encephalopathy are common complications arising from cirrhosis. The aim of this paper is to report a case of a patient with liver cirrhosis and the complications of a transjugular intrahepatic portosystemic shunt. Male, elderly, and ex-alcoholic, diagnosed with liver cirrhosis, ascites, and esophageal varices. He underwent transjugular intrahepatic portosystemic shunt due to portal hypertension and returned to the hospital after 24 hours with agitation and mental confusion. He had a bowel movement stop, neurological worsening, loss of renal function, hepatic hydrothorax, hepatic encephalopathy, hypernatremia, hypocalcemia, and hypophosphatemia. He underwent a new procedure to occlude the transjugular intrahepatic portosystemic shunt, showing improvement of the mental status and ascites. However, continued with decompensation and hydro-electrolytic disorders. He evolved with worsening of the ventilatory pattern, and neurological and renal function, with a fatal outcome. Esophageal varices due to portal hypertension can be corrected with the transjugular intrahepatic portosystemic shunt. however, complications such as hypernatremia, hepatic hydrothorax, and hepatic encephalopathy may occur. Therefore, there is a need for reintervention to shunt or reduce its caliber. Thus, for patients with advanced age and decompensated cirrhosis, the potential risks and benefits of this procedure should be carefully evaluated due to the risk of complications and death.

关键词： Ascites hypernatremia Portasystemic Shunt Transjugular Intrahepatic hepatic Encephalopathy

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Role of Cognitive Behavioral Therapy in Fibromyalgia: A Systematic Review

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Open Journal of Rheumatology and Autoimmune Diseases 2021年第4期11卷 169-187页

作者： heloisa Lima heller Aline Rizzo Borges Luís Otávio Amarante Franco João Pedro De Oliveira Aucelio Marcos Igor Albanaz Vargas Rebeca Naoum Lorga Mirella Bastos Sales Natália Vargas Do Nascimento gabriela Furlan Ribeiro Barbosa Netto Beatriz Carneiro Passos Beatriz Pires Paes Beatriz Toledo Mendes Bruna De Paula Gonçalves Sousa Lyra Ciro Moisés Oliveira Vieira Dos Santos Gustavo Araújo Do Nascimento Santos Maria Luiza Pimentel De Oliveira Matheus Macêdo Da Silva Maurício Silva De Jesus Paulo Ricardo Guimaraes Rocha Storni Tamires Martinelli De Oliveira Ferraz Viviane Cristina Uliana Peterle Ana Paula Monteiro Gomides Reis Centro Universitário de Brasília Brasília Brazil Universidade Católica de Brasília Brasília Brazil Centro Universitário Euro Americano Brasília Brazil

A literature search of articles from 2002-2019 was performed using Medline, Embase, Cochrane, LILACS, IBECS, CRD, and Epistemonikos databases, to analyze the effects of Cognitive-Behavioral Therapy (CBT) in the treatment of fibromyalgia. Twenty-seven articles were selected in which CBT was performed exclusively by specialist physicians, associated or not with conventional pharmacological treatment and/or physical exercise. In most articles, CBT worked with self-knowledge and cognitive restructuring, attempting to reduce pain perception, and it showed a general improvement in daily activities by decreasing patient’s limitations, such as morning stiffness. The literature showed significant correlations of CBT in pain processing over time. When CBT was compared to conventional pharmacological therapy, a certain superiority of CBT could be observed concerning the quality of life, catastrophizing, and acceptance of pain. however, when they were simultaneously applied, this improvement in quality of life was not observed.

关键词： Cognitive Behavioral Therapy Fibromyalgia Pain

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