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Embolization of splenorenal shunt associated to portal vein thrombosis and hepatic encephalopathy

World journal of Gastroenterology 2014年第42期20卷 15910-15915页

作者： Letícia de Campos Franzoni Fábio Cardoso de Carvalho Rafael Gomes de Almeida Garzon Fábio da Silva Yamashiro Laís Augusti Lívia Alves Amaral Santos Mariana de Souza Dorna júlio pinheiro baima Talles Bazeia Lima Carlos Antonio Caramori Giovanni Faria Silva Fernando Gomes Romeiro Internal Medicine Department Gastroenterology Division Botucatu Medical School UNESP 18 618 970 Botucatu Sao Paulo Brazil Hospital do Cora??o do Instituto de Moléstias Cardiovasculares S?o José do Rio Preto Sao Paulo 15015-210 Brazil Department of Internal Medicine Division of Cardiology Botucatu School of Medicine UNESP Univ Estadual Paulista

Hepatic encephalopathy(HE)is a cognitive disturbance characterized by neuropsychiatric *** occurs in acute and chronic hepatic disease and also in patients with portosystemic *** presence of these portosystemic shunts allows the passage of nitrogenous substances from the intestines through systemic veins without liver ***,the embolization of these shunts has been performed tocontrol HE manifestations,but the presence of portal vein thrombosis is considered a *** this presentation we show a cirrhotic patient with severe HE and portal vein thrombosis who was submitted to embolization of a large portosystemic *** report:a 57 years-old cirrhotic patient who had been hospitalized many times for persistent HE and hepatic coma,even without precipitant *** had a wide portosystemic shunt and also portal vein *** abdominal angiography confirmed the splenorenal shunt and showed other *** larger shunt was embolized through placement of microcoils,and the patient had no recurrence of overt *** was a little increase of esophageal and gastric varices,but no endoscopic treatment was *** portosystemic shunts are frequent causes of recurrent HE in cirrhotic patients,portal vein thrombosis should be considered a relative contraindication to perform a shunt ***,in particular cases with many shunts and severe HE,we found that one of these shunts can be safely embolized and this procedure can be sufficient to obtain a good HE *** conclusion,we reported a case of persistent HE due to a wide portosystemic shunt associated with portal vein *** the patient had other shunts,she was successfully treated by embolization of the larger shunt.

关键词： Recurrent hepatic encephalopathy Liver cirrhosis Port systemic shunt Shunt embolization Portal vein thrombosis

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Liver biopsy for visceral leishmaniasis diagnosis in pregnancy: report of 2 cases

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World journal of Clinical Infectious Diseases 2013年第2期3卷 20-24页

作者： Talles Bazeia Lima Clarissa Ribeiro Villar Maria Aparecida Marchesan Rodrigues júlio pinheiro baima Fábio da Silva Yamashiro Letícia Campos Franzoni Carlos Antonio Caramori Giovanni Faria Silva Fernando Gomes Romeiro Lígia Yukie Sassaki Department of Internal Medicine Division of GastroenterologyBotucatu School of MedicineSao Paulo18618-970Brazil Department of Pathology Botucatu School of MedicineSao Paulo18618-970Brazil

Visceral leishmaniasis(VL) or kala-azar is a zoonosis caused by intracellular protozoa of the Leishmania genus and is transmitted to humans by the bite of phlebotomine sandflies. It particularly affects cells in the phagocytic mononuclear system, accompanied by disturbances of cellular and humoral immunity. VL is potentially fatal and is characterized by fever, hepatosplenomegaly, diarrhea, epistaxis, jaundice, anemia, leucopenia, thrombocytopenia, hypoalbuminemia and hyperglobulinemia. Diagnostic suspicion is based on epidemiological, clinical and laboratory data and isconfirmed by detecting the parasite in infected tissue. Splenic aspiration is the most sensitive method, followed by bone marrow aspiration(BMA) by sternal puncture, liver biopsy and lymph node aspiration; but, due to safety concerns, BMA is the most recommended method. VL is included as a target disease by players in drug research and development. Severe liver dysfunction associated with VL is uncommon. We report two VL cases in pregnant women from Bauru, Sao Paulo state, Brazil, considered an endemic area. The first of them developed hepatic failure due to fulminant hepatitis. In both cases, BMA was unable to find the protozoan; thus, liver biopsy was the only means of making the diagnosis.

关键词： Visceral Leishmaniasis Infection in pregnancy Liver biopsy Bone marrow aspirate Differential diagnosis

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Design and redesign journey of a drug for transthyretin amyloidosis

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Neural Regeneration Research 2025年第4期20卷 1096-1097页

作者： Francisca pinheiro Salvador Ventura Institut de Biotecnologia i Biomedicina Departament de Bioquímica i Biologia MolecularUniversitat Autònoma de BarcelonaBellaterraSpain

The misfolding and subsequent aggregation of proteins into amyloid fibrils underlie the onset of a variety of human disorders collectively known as ***(TTR)is one of the>30 amyloidogenic proteins identified to date and is associated with a group of highly debilitating and life-threatening disorders called TTR amyloidosis(ATTR).ATTR comprises senile systemic amyloidosis,which is linked to wild-type(WT)TTR aggregation,and hereditary ATTR,a dominantly inherited disorder caused by the deposition of one of over 130 TTR genetic *** systemic amyloidosis is a prevalent age-related amyloidosis,affecting up to 25%of the population over 80 years of age,and is characterized by the build-up of TTR fibrils in the *** hereditary ATTR,the clinical presentation is highly heterogeneous,primarily affecting the peripheral nervous system(familial amyloid polyneuropathy-FAP)or the heart(familial amyloid cardiomyopathy).In rare cases,aggregation develops in the central nervous system,giving rise to a phenotype known as familial leptomeningeal amyloidosis(Carroll et al.,2022).

关键词： amyloid aggregation senile

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Archean-Ediacaran evolution of the Campos Gerais Domain-A reworked margin of the São Francisco paleocontinent(SE Brazil):Constraints from metamafic-ultramafic rocks

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Geoscience Frontiers 2022年第5期13卷 286-308页

作者： Marco Aurélio Piacentini pinheiro George L.Guice joana Reis Magalhães Geological Survey of Brazil–CPRM Av Brazil 1731Belo Horizonte 30140-002Brazil Department of Mineral Sciences National Museum of Natural HistorySmithsonian Institution10th Street and Constitution Avenue NWWashington D.C.20560USA

The Campos Gerais Domain(CGD)in southeastern Brazil is an approximately 180 km×35 km area of Archean–Proterozoic rocks located southwest of the São Francisco Craton(SFC).The Archean–Paleopro terozoic evolution of the CGD—alongside its potential correlation with the SFC or other cratonic blocks in the region-is currently *** present the results of systematic petrography,bulkrock geochemistry,mineral chemistry and geochronology for a suite of scarcely studied mafic–ultramafic rocks from the *** also provide a compilation of previously reported bulk-rock geochemical and spinel group mineral chemical data for mafic–ultramafic rocks throughout the CGD,and geochronological information for various lithotypes in the *** CGD records a protracted Mesoarchean to Statherian(3.1–1.7 Ga)crustal evolution,which we interpret to share a common history with the southern SFC and their related reworked segments,suggesting that it is a westward extension of this cratonic *** metavolcano-sedimentary rocks of the Fortaleza de Minas and Alpinópolis segments represent a Mesoarchean greenstone belt that is stratigraphically and chemically comparable to Archean greenstone belts worldwide,and that is broadly coeval with a local suite of tonalite-trondhjemite-grano diorite(TTG)gneisses and migmatites.U-Pb SHRIMP zircon data from a subalkaline metagabbro yielded a concordia age of ca.2.96 Ga,revealing a previously unrecognized phase of Archean magmatism in the CGD that can be chrono-correlated with metakomatiite and TTG generation elsewhere in the São Francisco *** data contradict a hypothesis whereby the metavolcano-sedimentary rocks of the jacuí-Bom jesus da Penha and Petúnia segments represent an ophiolite,as previously suggested,instead presenting features that point to formation in association with a continental *** with a U-Pb(SHRIMP)crystallization age of ca.2.13 Ga recorded by zircon grains from a metaultramafic rock,these data h

关键词： Komatiites São Francisco Craton Southern Brasília Orogen Archean geodynamics Rhyacian orogeny

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MicroRNA expression in inflammatory bowel disease-associated colorectal cancer

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World journal of Gastrointestinal Oncology 2021年第9期13卷 995-1016页

作者： Thais Gagno Grillo Ana Elisa Valencise Quaglio Rodrigo Fedatto Beraldo Talles Bazeia Lima julio pinheiro baima Luiz Claudio Di Stasi Ligia Yukie Sassaki Department of Internal Medicine São Paulo State University(Unesp)Medical SchoolBotucatu 18618-686São PauloBrazil Department of Biophysics and Pharmacology São Paulo State University(Unesp)Institute of BiosciencesBotucatu 18618-689São PauloBrazil

MicroRNAs(miRNAs)are non-coding RNA molecules composed of 19–25 nucleotides that regulate gene expression and play a central role in the regulation of several immune-mediated disorders,including inflammatory bowel diseases(IBD).IBD,represented by ulcerative colitis and Crohn’s disease,is characterized by chronic intestinal inflammation associated with an increased risk of colorectal cancer(CRC).CRC is one of the most prevalent tumors in the world,and its main risk factors are obesity,physical inactivity,smoking,alcoholism,advanced age,and some eating habits,in addition to chronic intestinal inflammatory processes and the use of immunosuppressants administered to IBD *** studies have identified miRNAs associated with an increased risk of developing CRC in this *** identification of miRNAs involved in this tumorigenic process could be useful to stratify cancer risk development for patients with IBD and to monitor and assess ***,the present review aimed to summarize the role of miRNAs as biomarkers for the diagnosis and prognosis of IBD-associated *** the future,therapies based on miRNA modulation could be used both in clinical practice to achieve remission of the disease and restore the quality of life for patients with IBD,and to identify the patients with IBD at high risk for tumor development.

关键词： MicroRNA Colorectal cancer Inflammatory bowel disease Crohn's disease Ulcerative colitis Cancer Diagnosis Prognosis Targets

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Gut-microbiome-brain axis:the crosstalk between the vagus nerve,alpha-synuclein and the brain in Parkinson's disease

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Neural Regeneration Research 2023年第12期18卷 2611-2614页

作者： júlio César Claudino dos Santos Leandro Freitas Oliveira Felipe Micelli Noleto Camilla Teixeira pinheiro Gusmão Gerly Anne de Castro Brito Glauce Socorro de Barros Viana Christus University Center-UNICHRISTUS FortalezaCEBrazil Postgraduate Program in Morphofunctional Sciences Federal University of Ceará-UFCFortalezaCEBrazil Universidade Católica de Brasília-UCB BrasíliaDFBrasil Postgraduate Program in Physiology and Pharmacology Department of the Federal University of Ceará-UFC FortalezaCEBrazil Physiology and Pharmacology Department of the Federal University of Ceará-UFC FortalezaCEBrazil

This critical review of the literature shows that there is a close link between the microbiome,the gut,and the brain in Parkinson's *** vagus nerve,the main component of the parasympathetic nervous system,is involved in the regulation of immune response,digestion,heart rate,and control of *** can detect microbiota metabolites through its afferents,transferring this gut information to the central nervous *** and clinical studies have shown the important role played by the gut microbiome and gut-related factors in disease development and progression,as well as treatment *** findings suggest that the gut microbiome may be a valuable target for new therapeutic strategies for Parkinson's *** studies are needed to better understand the underlying biology and how this axis can be modulated for the patient's benefit.

关键词： alpha-synuclein enteric microbiota gastrointestinal tract Parkinson's disease vagus nerve

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Treatment of acute severe ulcerative colitis using accelerated infliximab regimen based on infliximab trough level:A case report

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World journal of Clinical Cases 2021年第13期9卷 3219-3226页

作者： Ana Lorena Sousa de Vasconcelos Garate Thiara Barcelos Rocha Luciana Rocha Almeida Rodrigo Quera jaqueline Ribeiro Barros julio pinheiro baima Rogerio Saad-Hossne Ligia Yukie Sassaki Department of Internal Medicine São Paulo State University(Unesp)Medical SchoolBotucatu 18618687São PauloBrazil Inflammatory Bowel Disease Program GastroenterologyMedicine DepartmentClínica Universidad de los AndesSantiago 7550000Chile

BACKGROUND Acute severe ulcerative colitis (ASUC) is a complication of ulcerative colitisassociated with high levels of circulating tumor necrosis factor alpha, due to theintense inflammation and faster stool clearance of anti-tumor necrosis factordrugs. Dose-intensified infliximab treatment can be beneficial and is associatedwith lower rates of colectomy. The aim of the study was to present a case of apatient with ASUC and megacolon, treated with hydrocortisone and acceleratedscheme of infliximab that was monitored by drug trough *** SUMMARYA 22-year-old female patient diagnosed with ulcerative colitis, presented withdiarrhea, rectal bleeding, abdominal pain, vomiting, and distended *** investigation, a positive toxin for Clostridium difficile and colonic dilatationof 7 cm consistent with megacolon were observed. She was treated with oralvancomycin for pseudomembranous colitis and intravenous hydrocortisone forsevere colitis, which led to the resolution of megacolon. Due to the persistentsevere colitis symptoms, infliximab 5 mg/kg was prescribed, monitored by drugtrough level (8.8 μg/mL) and fecal calprotectin of 921 μg/g (< 30 μg/g). Based onthe low infliximab trough level after one week from the first infliximab dose, thepatient received a second infusion at week 1, consistent with the acceleratedregimen (infusions at weeks 0, 1, 2 and 6). We achieved a positive clinical andendoscopic response after 6 mo of therapy, without the need for a *** accelerated infusions can be beneficial in ASUC unresponsive to thetreatment with intravenous corticosteroids. Longitudinal studies are necessary todefine the best therapeutic drug monitoring and treatment regimen for thesepatients.

关键词： Infliximab Acute severe ulcerative colitis Toxic megacolon Ulcerative colitis Inflammatory bowel disease Case report

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Quality of care in patients with inflammatory bowel disease from a public health center in Brazil

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World journal of Clinical Cases 2022年第33期10卷 12184-12199页

作者： Debora Mayumi Takamune Giovana Signorelli Astolfi Cury Giulia Ferrás Giedre Soares Prates Herrerias Adriana Rivera jaqueline Ribeiro Barros julio pinheiro baima Rogerio Saad-Hossne Ligia Yukie Sassaki Department of Internal Medicine São Paulo State University(Unesp)Medical SchoolBotucatu 18618686São PauloBrazil Research Unit Virgen Macarena University HospitalSeville 41009Spain Department of Medicine Nove de Julho UniversityBauru 17011-102São PauloBrazil Department of Surgery São Paulo State University(Unesp)Medical SchoolBotucatu 18618686São PauloBrazil

BACKGROUND Inflammatory bowel diseases(IBDs)are chronic diseases that demand continuous interaction between patients and healthcare *** of care(QoC)is a factor that contributes to a patient’s adherence to treatment and its *** To evaluate QoC in patients from a single IBD reference *** This cross-sectional study included 133 patients from a single Brazilian IBD public health *** was evaluated through the QoC Through the Eyes of Patients with IBD(QUOTE-IBD)questionnaire(based on patient perspectives),which measures eight dimensions of *** compared QoC among patients with Crohn’s disease and ulcerative colitis and analyzed the clinical and psychological factors associated with QoC *** evaluations assessed disease characteristics,quality of life,anxiety,and depression *** Sixty-nine patients with Crohn’s disease and 64 with ulcerative colitis were *** mean age was 37.26 years±13.05 years,and 63.91%of the patients were *** mean duration of the disease was 8.44 years±7.59 years,where most patients were in remission(70.31%of patients with ulcerative colitis and 62.32%with Crohn’s disease).The total QoC score of the sample was 8.61 years±1.31 points,indicating that the QoC provided by the center was *** to univariate logistic regression,patients with Crohn’s disease had higher satisfaction rates than those with ulcerative colitis[odds ratio(OR):2.746;95%confidence interval(CI):1.360-5.541;P=0.0048]and patients on infliximab(OR:2.175;95%CI:1.037-4.562;P=0.0398).CONCLUSION Patients from the IBD public center reported good doctor-patient relationships,but had problems related to the healthcare *** of healthcare centers is of paramount to improve QoC for the patients involved.

关键词： QUOTE-IBD questionnaire Quality of care Crohn’s disease Ulcerative colitis Inflammatory bowel disease Doctor-patient relationship

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Non-Hodgkin＇s Lymphoma： An Important Differential Diagnosis in Inflammatory Bowel Disease

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Chinese Medical journal 2018年第11期131卷 1377-1378页

作者： Rogerio Saad-Hossne Carina De Fatima De Sibia julio pinheiro baima Ligia Yukie Sassaki Department of Surgery Division of Coloproctology Botucatu Medical School Sao Paulo State University-UNESP Botucatu SP 18618-687 Brazil Department of Internal Medicine (Gastroenterology) Botucatu Medical School Sao Paulo State University-UNESP Botucatu SP 18618-687 Brazil

To the Editor： The gastrointestinal tract （GIT） is the most common extranodal location ofnon-Hodgkin＇s lymphoma, but it represents only 0.4% of primary colonic malignancies. Symptoms are nonspecific and may include diarrhea, constipation, abdominal pain, weight loss, and gastrointestinal bleeding. In colon, the most common types are conventional large cell lymphoma, mucosa-associated lymphoid tissue lymphoma, and T-cell lymphoma.

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Accuracy details in realistic CFD modeling of an industrial centrifugal pump in direct and reverse modes

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journal of Thermal Science 2010年第6期19卷 491-499页

作者： j.C. Páscoa F. j. Silva j.S. pinheiro D.j. Martins Department of Electromechanical Engineering Center for Aerospace Sciences and Technology University of Beira Interior EFAFLU Bombas e Ventiladores S.A. R. S. Brás 269 Apartado 23 4494-909 Póvoa do Varzim Portugal

Numerical computation of the flowfield inside a pump is herein used as a numerical laboratory, subject to the limitations of modeling assumptions and to experimental verification. A numerical computation of the flow inside a real industrial centrifugal pump is performed that includes a very sophisticated geometry. Conversely to other computations, in this test case no simplification of the geometry was introduced. Numerical computations are obtained using Spalart-Allmaras turbulence model. A detailed analysis of the turbulent flowstructure is performed for the design point and two off design conditions. Additional computations were performed in order to compare the numerical and experimental pump characteristics; these were obtained under normalized testing conditions. Further computations are presented for the pump working in reverse turbine mode (PAT). Detailed analyses of the flow allow a comparison of the internal flow losses when the pump is operating in direct and reverse mode. This is also useful to help in the selection of an adequate pump geometry that can work in both modes with best efficiency.

关键词： centrifugal pump impeller turbulence modeling Spalart-Allmaras PAT

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