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Endoscopic mucosal resection and endoscopic submucosal dissection in the treatment of sporadic nonampullary duodenal adenomatous polyps

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World Journal of Gastrointestinal Endoscopy 2015年第7期7卷 720-727页

作者： joana marques Francisco Baldaque-Silva Pedro Pereira Urban Arnelo Naohisa Yahagi Guilherme Macedo Faculty of Medicine University of Porto Gastrocentrum Karolinska University Hospital Karolinska Institutet Gastroenterology Department Hospital Sao Joao Department of Clinical Science Intervention and Technology (CLINTEC) Karolinska Institutet and Centre for Digestive Diseases Karolinska University Hospital Division of Research and Development for Minimally Invasive Treatment Cancer Center School of Medicine Keio University

Although uncommon, sporadic nonampullary duodenal adenomas have a growing detection due to the widespread of endoscopy. Endoscopic therapy is being increasingly used for these lesions, since surgery, considered the standard treatment, carries significant morbidity and mortality. However, the knowledge about its risks and benefits is limited, which contributes to the current absence of standardized recommendations. This review aims to discuss the efficacy and safety of endoscopic mucosal resection(EMR) and endoscopic submucosal dissection(ESD) in the treatment of these lesions. A literature review was performed, using the Pubmed database with the query: "(duodenum or duodenal)(endoscopy or endoscopic) adenoma resection", in the human species and in English. Of the 189 retrieved articles, and after reading their abstracts, 19 were selected due to their scientific interest. The analysis of their references, led to the inclusion of 23 more articles for their relevance in this subject. The increased use of EMR in the duodenum has shown good results with complete resection rates exceeding 80% and low complication risk(delayed bleeding in less than 12% of the procedures). Although rarely used in the duodenum, ESD achieves close to 100% complete resection rates, but is associated with perforation and bleeding risk in up to one third of the cases. Even though literature is insufficient to draw definitive conclusions, studies suggest that EMR and ESD are valid options for the treatment of nonampullary adenomas. Thus, strategies to improve these techniques, and consequently increase the effectiveness and safety of the resection of these lesions, should be developed.

关键词： Polyps Duodenum Adenoma Resection Endoscopy

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Ophthalmic adverse drug reactions:A nationwide detection using hospital databases

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World Journal of Meta-Analysis 2013年第2期1卷 78-82页

作者： Ana Miguel Filipe Henriques Bernardo marques joana marques Alberto Freitas Fernando Lopes Luís Azevedo Altamiro Costa Pereira Centre for Research in Health Technologies and Information Systems Faculty of Medicine University of Porto Department of Ophthalmology Central University Hospital of Coimbra Northern Pharmacovigilance Centre Faculty of Medicine University of Porto

AIM: To detect ophthalmic adverse drug reactions(ADRs), that occurred in Portugal from 2000 to 2009, through the utilization of administrative hospital databases. We also intended to compare the results of this methodology with spontaneous ***: We conducted a retrospective nationwide study using hospital administrative databases, which included all inpatients and outpatients in all public hospitals in Portugal, from 2000 to 2009. We used International Classification of Diseases- 9th Revision- Clinical Modification(ICD-9-CM) coding data that allowed the detection of ADRs. We used WHO's definition for ADR. We searched all of ICD-9-CM terms in Ophthalmology for codes that included "drug-induced", "iatrogenic", "toxic" and all other that could signal an ADR, such as "362.55- toxic maculopathy" or "365.03- steroid responders", and also "E" codes(codes from E930 to E949.9, that exclude intoxications and errors).RESULTS: From 11944725 hospitalizations or ambulatory episodes within that period of time, we identified 1524 probable ophthalmic ADRs(corresponding to a frequency of 1.28 per 10000 episodes) and an additional 100 possible ophthalmic ADRs. We used only 4 person-hours in the application of this methodology. A total of 113 spontaneous reports arose from ophthalmic ADRs from 2000 to 2009 in Portugal(frequency of 0.095 per 10000 episodes).To our knowledge, this was the first estimate of the frequency of ophthalmic ADRs through the use of databases, and the first nationwide estimate of ophthalmic ADRs, in Portugal. We identified 1524 probable ADRs and 100 possible ADRs. CONCLUSION: This database methodology adapted for Ophthalmology may represent a new approach for the detection of ophthalmic ADRs, since these codes exist in the ICD-9-CM classification. Its performance was clearly superior to spontaneous reporting.

关键词： Adverse drug reactions Ophthalmology Ocular Databases Pharmacovigilance

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^(99m)Tc in the evaluation of microleakage of composite resin restorations with SonicFill^(TM).An in vitro experimental model

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Open Journal of Stomatology 2012年第4期2卷 340-347页

作者： Carrilho Eunice Abrantes Margarida Casalta-Lopes Joao Botelho Filomena Paula Anabela Ambrósio Pedro Marto Carlos Miguel Rebelo Diana marques joana Polido Mário Ferreira Manuel marques Faculty of Medicine University of CoimbraCoimbraPortugal

Introduction: The composite SonicFillTM (Kerr/Kavo) is indicated for posterior restorations, with a single increment up to 5 mm due to reduced polymerization shrinkage, thus reducing working time. Aim: Evaluation of marginal microleakage with SonicFillTM. Method and Materials: There were sectioned sixty noncarious human molars in the occluso-cervical direction. Class V cavities were prepared on each tooth with gingival margin walls in a standardized way. The specimens were divided into 4 groups: group 1—restored with SonicFillTM (Kerr/Kavo), group 2—restored with FiltekTM SupremeXTE (3M ESPE), group 3—the cavities were not restored;group 4—restored with SonicFillTM (Kerr/Kavo). In groups 1, 2 and 4 the enamel was conditioned with 37% orthophosphoric acid and applied the self-etch adhesive system Clear- fillTM SE BOND (Kuraray). The specimens were stored in distilled water at 37?C for 7 days. After, the specimens, were immersed in a solution of 99mTc-Pertechnetate and the radioactivity was assessed with a gamma camera. The nonparametric Kruskal-Wallis and Mann-Whitney test with Bonferroni correction at a significance level of 5% were used for the statistical analyses. Results: There are significant differences between the positive and negative control groups and between these and experimental groups (p TM and FiltekTM SupremeXTE. Conclusion: The new composite SonicFillTM and FiltekTM SupremeXTE showed no difference concerning dye penetration. The Sonic- FillTM restorative system showed no influence in concerning microleakage.

关键词： Posterior resin Composites Composite Restorations Polymerization Stress Polymerization Shrinkage Microleakage Thermocycling

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Ozone action on Streptococcus mutans and Lactobacillus fermentum : A pilot study

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World Journal of Stomatology 2013年第1期2卷 18-23页

作者： joana marques Anabela Paula Teresa Gon?alves Manuel Ferreira Eunice Carrilho Faculty of Medicine the University of Coimbra Area of Dentistry Av Bissaya Barreto Blocos de Celas 3000-075 Coimbra Portugal

AIM: To study the effectiveness of ozone in the elimination of cariogenic bacteria, followed with fluoride ***: Sixty extracted teeth free of caries were used, and five groups were constituted. In Group Ⅰ,the teeth were immersed in artificial saliva. In Group Ⅱ,the teeth were inoculated with Streptococcus mutans(S. mutans) and immersed in artificial saliva. In GroupⅢ the teeth were inoculated with Lactobaccilus fermentum(L. fermentum) and immersed in artificial *** Group Ⅳ the teeth were inoculated with S. mutans and L. fermentum and immersed in artificial saliva and the teeth in Group Ⅴ were inoculated with S. mutans and L. fermentum, and were subjected to the application of ozone and to the action of a fluoride mineralizing gel. DIAGNOdent was used to evaluate the caries of the teeth 3 wk after inoculation of bacteria and after that the teeth of Group Ⅴ were subjected to the application of ozone during 60 s, by HealO zone. After the application of ozone, products of the remineralization kit supplied by the manufacturer were applied daily, during 30 d. At the end samples were collected for analysis and evaluation of bacterial activity by polymerase chain reaction. RESULTS: Regarding the value of caries, obtained via DIAGNOdent, in the initial measurement the groups are homogeneous(P = 0.730). There was an increase in DIAGNOdent values, presenting statistical significant difference regarding the initial measurement in all groups(P < 0.001), except in group Ⅰ- only artificial saliva- which shows that the artificial carie model was effective. Comparing the initial and final measurements for each of the 60 teeth, it can be observed that in 9 teeth(15.0%) there was a decrease in values between the two measurements, one(1.7%) retained the same values in the two measurements and in the remaining 50 cases(83.3%) there was increase in values between the initial and final measurements. It should also be noted that in the teeth inoculated with S. mutans

关键词： Dental caries Cariogenic agents Lactobaccilus fermentum Streptococcus mutans Ozone

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Adenosine A2A receptors induce the formation of abnormal secondary axons in rat hippocampal neurons: a new target to arrest epileptogenesis

Adenosine A2A receptors induce the formation of abnormal sec...

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中国神经科学学会第十二届全国学术会议

作者： Xinli Xu Sofia Al?ada-Morais Nélio M.Gon?alves joana M.marques Sergio Valbuena Rui O.Beleza Francisco Q.Gon?alves Sofia Ferreira Juan Lerma Rodrigo A.Cunha Ricardo J.Rodrigues CNC-Center for Neuroscience and Cell Biology University of Coimbra

Current anti-epileptic drugs mostly control convulsions with a limited efficacy, and do not seize epileptogenesis. One of the structural-functional modifications occurring during epileptogenesis is an abnormal axonal sprouting. The hippocampal mossy fiber(MF) sprouting found in patients and in animal models of temporal lobe epilepsy(TLE)(Neuroscience14, 375-403) generates an aberrant excitatory feedback circuit in granule cells that is thought to contribute to the hyperexcitability underlying the seizure-prone state(Neurochem. Res.28, 1649-58). However, the mechanism underlying this aberrant re-wiring is still poorly understood. There is now a growing evidence for a sustained increase in extracellular ATP levels in different pathological conditions, prompting ATP as a danger signal in the brain(Front. Neurosci.9:148). Accordingly, we now measured a sustained increase of the evoked release of ATP from hippocampal nerve terminals of Sprague-Dawley rats subjected to Status Epilepticus(SE) induced by pilocarpineinjection. Concomitantly, we found in developing rat hippocampal neurons that the pharmacological activation of adenosine A receptors(ARs) with the selective agonist CGS21680(30 n M) induces the formation of abnormal secondary axons. This prompted us to propose that this abnormal sprouting is due to an abnormal reactivation of the developmental-related AR-driven axon formation and outgrowth. We have now found in hippocampal organotypic slices that the spontaneous MF sprouting was attenuated by the pharmacological blockade of ARs, since the current densities(p A/p F) recorded were significantly lower in the slices cultured in the presence of the selective AR antagonist SCH58261(100 n M). More importantly, we found that the animals subjected to a long-term systemic treatment with SCH58261(0.1 mg/kg, i.p.), beginning 10 hours after pilocarpine-induced SE in rats, displayed significantly less hippocampal MF sprouting. Interestingly, CD73 knockout(CD73 KO) mice(lackin

关键词： A2A receptors Mossy fiber sprouting Status epilepticus CD73

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Evaluation of Novel 3D Architectures Based on Knitting Technologies for Engineering Biological Tissues

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Journal of Donghua University(English Edition) 2013年第5期30卷 421-426页

作者： RIBEIRO Viviana Pinto RIBEIRO Ana Soares SILVA Carla joana DURES Nelson Feio BONIFCIO Graa CORRELO Vitor Manuel marques Alexandra Pinto SOUSA Rui Amandi OLIVEIRA Ana Leite REIS Rui Luís 3B's Research G roup-Biomaterials Biodegradables and BiomimeticsUniversity of MinhoHeadquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine ICVS /3B's-PT G overnment Associated Laboratory University of Minho CeNTI Centre for Nanotechnology and Smart MaterialsV. N. CITEVE Technological Centre for Textile and Clothing IndustryV. N. CBQF-School of Biotechnology Portuguese Catholic University

Textile-based technologies are considered as potential routes for the production of 3D porous architectures for tissue engineering( TE) applications. We describe the use of two polymers,namely polybutylene succinate( PBS) and silk fibroin(SF) to produce fiber-based finely tuned porous architectures by weft and warp knittings. The obtained knitted constructs are described in terms of their morphology, mechanical properties,swelling ability,degradation behaviour,and cytotoxicity. Each type of polymer fibers allows for the processing of a very reproducible intra-architectural scaffold geometry,with distinct characteristics in terms of the surface physicochemistry,mechanical performance,and degradation capability,which has an impact on the resulting cell behaviour at the surface of the respective biotextiles. Preliminary cytotoxicity screening shows that both materials can support cell adhesion and proliferation. Furthermore, different surface modifications were performed( acid /alkaline treatment, UV radiation,and plasma) for modulating cell behavior. An increase of cell-material interactions were observed,indicating the important role of materials surface in the first hours of culturing. Human adipose-derived stem cells( hASCs) became an emerging possibility for regenerative medicine and tissue replacement therapies. The potential of the recently developed silk-based biotextile structures to promote hASCs adhesion,proliferation,and differentiation is also evaluated. The obtained results validate the developed constructs as viable matrices for TE applications. Given the processing efficacy and versatility of the knitting technology, and the interesting structural and surface properties of the proposed polymer fibers,it is foreseen that our developed systems can be attractive for the functional engineering of tissues such as bone,skin,ligaments or cartilage and also for develop more complex systems for further industrialization of TE products.

关键词： textile-based technologies silk polybutylene succinate(PBS) surface modifications human adipose-derived stem cells(hASCs) tissue engineering(TE)

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Emerging and under-recognized Chagas cardiomyopathy in non-endemic countries

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World Journal of Cardiology 2012年第7期4卷 234-239页

作者： joana Cortez Rui Providência Evelise Ramos Cristina Valente Jorge Seixas Manuela Meruje António Leito-marques António Vieira Infectious Diseases Department Coimbra's Hospital Centre and University Cardiology Department Coimbra's Hospital Centre and University Hygiene and Tropical Medicine Institute Universidade Nova de Lisboa Pathology Department Coimbra's Hospital Centre and University

Due to recent population emigration movements,an epidemic of Chagas disease is currently menacing most developed *** authors report the case of a 53-year-old Brazilian woman living in Europe for the last 10 years who developed heart failure symptoms,having a previous symptomatic sinus node disease with a pacemaker implant at age of 40 *** diagnosis was based on serology and myocardial biopsy and the patient was treated with *** authors emphasize the need of a high level of suspicion in patients with suggestive epidemiology and the needof populational screening of specific high risk *** treatment options are also discussed.

关键词： Chagas disease Chagas cardiomyopathy Dysrhythmia Emigration Non-endemic countries Benznidazole Nifurtimox

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