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Solutions for submucosal injection: What to choose and how to do it

World Journal of Gastroenterology 2019年第7期25卷 777-788页

作者： Rui Castro Diogo Libanio Inês Pita mário dinis-ribeiro Department of Gastroenterology Portuguese Oncology Institute of Porto CIDES/CINTESIS Faculty of Medicine University of Porto

During the past decades, endoscopic resection techniques have gradually improved and gained more importance for the management of premalignant lesions and early cancers. These endoscopic resection techniques can be divided in 3 major groups: snare polipectomy, endoscopic mucosal resection(EmR) and endoscopic submucosal dissection(ESD). The use of submucosal injection is essential for the majority of EmR techniques and is an integral part of ESD,whereas during polipectomy it is not crucial in most cases except to prevent bleeding in large polyps and/or those with large stalks as an alternative to mechanical methods. Injection provides a lifting up effect of the lesion separating it from the muscular layer, thereby reducing thermal injury and the risk of perforation and bleeding while also facilitating en-bloc resection by improving technical feasibility. With this work, we aim to review the most common endoscopic resection techniques and the importance of submucosal injection in each one of them. For that, we present some of the most commonly used submucosal injection solutions, taking into account their advantages and disadvantages. We also discuss, based on current recommendations and our own experience, how and when to preform submucosal injection, depending on lesions features and endoscopic resection technique that′s being used, to assure complete resection and to prevent associated adverse events. Finally, we also present and discuss some new proposed submucosal injection solutions,endoscopic resection techniques and devices that may have a major impact on the future of therapeutic endoscopy.

关键词： Snare polipectomy Endoscopic mucosal resection Endoscopic submucosal dissection Submucosal injection Submucosal injection solution

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Association between EGF +61A/G polymorphism and gastric cancer in Caucasians

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World Journal of Gastroenterology 2011年第4期17卷 488-492页

作者： Ana Paula Araújo Bruno m Costa Ana L Pinto-Correia maria Fragoso Paula Ferreira mário dinis-ribeiro Sandra Costa Rui m Reis Rui medeiros molecular Oncology Group Portuguese Institute of Oncology of Porto Life and Health Sciences Research Institute (ICVS) School of Health Sciences Oncology Department Portuguese Institute of Oncology of Porto Gastroenterology Department Portuguese Institute of Oncology of Porto Portugal Cintesis/Faculty of medicine University of Porto Centro de Estudos em Biomedicina Health Sciences Faculty-Fernando Pessoa University Instituto de Ciencias Biomédicas de Abel Salazar Abel Salazar Institute for the Biomedical Sciences

AIm: To investigate the association between epidermal growth factor (EGF) +61A/G polymorphism and susceptibility to gastric cancer, through a cross-sectional study. mETHODS: Polymerase chain reaction resctriction fragment lenght polymorphism analyses were used to genotype EGF +61 in 207 patients with gastric lesions (162 patients with gastric adenocarcinomas, 45 with atrophy or intestinal metaplasia) and 984 controls. All subjects were Caucasian. RESULTS: Genotype distribution was 23.5% for GG and 76.5% for GA/AA in the control group, 18.4% for GG and 68.6% for GA/AA in the entire group with gastric lesions and 17.9% for GG and 82.1% for GA/AA in the group with gastric adenocarcinoma. No statistically significant associations were found between EGF +61 variants and risk for developing gastric cancer [odds ratios (OR) = 1.41, 95% confidence intervals (CI): 0.90-2.21, P = 0.116]. However, the stratification of individuals by gender revealed that males carrying A alleles (EGF +61A/G or AA) had an increased risk for developing gastric cancer as compared to GG homozygous males (OR = 1.55, 95% CI: 1.05-2.28, P = 0.021). CONCLUSION: In summary, we found that males who were A carriers for EGF +61 had an increased risk for developing gastric cancer. This result may be explained by the suggestion that women secrete less gastric acid than men.

关键词：多态性分析 EGF 白种人胃癌表皮生长因子协会聚合酶链反应片段长度

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Helicobacter pylori and microRNAs:Relation with innate immunity and progression of preneoplastic conditions

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World Journal of Clinical Oncology 2015年第5期6卷 111-132页

作者： Diogo Libanio mário dinis-ribeiro Pedro Pimentel-Nunes Gastroenterology Department Portuguese Oncology Institute Center for Health Technology and Services Resarch Faculty of Medicine University of Porto Department of Health Information and Decision Sciences Faculty of Medicine University of Porto Department of Physiology and Cardio- thoracic Surgery Cardiovascular Research and Development UnitFaculty of Medicine University of Porto

The accepted paradigm for intestinal-type gastric cancer pathogenesis is a multistep progression from chronic gastritis induced by Helicobacter pylori(H. pylori) to gastric atrophy, intestinal metaplasia, dysplasia and ultimately gastric cancer. The genetic and molecular mechanisms underlying disease progression are still not completely understood as only a fraction of colonized individuals ever develop neoplasia suggesting that bacterial, host and environmental factors are involved. micro RNAs are noncoding RNAs that may influence H. pylori-related pathology through the regulation of the transcription and expression of various genes, playing an important role in inflammation, cell proliferation, apoptosis and differentiation. Indeed, H. pylori have been shown to modify micro RNA expression in the gastric mucosa and micro RNAs are involved in the immune host response to the bacteria and in the regulation of the inflammatory response. micro RNAs have a key role in the regulation of inflammatory pathways and H. pylori may influence inflammation-mediated gastric carcinogenesis possibly through DNA methylation and epigenetic silencing of tumor suppressor micro RNAs. Furthermore, micro RNAs influenced by H. pylori also have been found to be involved in cell cycle regulation, apoptosis and epithelial-mesenchymal transition. Altogether, micro RNAs seem to have an important role in the progression from gastritis to preneoplastic conditions and neoplastic lesions and since each micro RNA can control the expression of hundreds to thousands of genes, knowledge of micro RNAs target genes and their functions are of paramount importance. In this article we present a comprehensive review about the role of micro RNAs in H. pylori gastric carcinogenesis, identifying the micro RNAs downregulated and upregulated in the infection and clarifying their biological role in the link between immune host response, inflammation, DNA methylation and gastric carcinogenesis.

关键词： Helicobacter pylori microRNA Gastric cancer Inflammation DNA methylation Preneoplastic conditions Stomach neoplasms Immune response

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Toll-Like Receptors as Biomarkers of Gastric Carcinogenesis:Implications for Diagnosis,Prognosis and Treatment

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Journal of Cancer Therapy 2013年第5期4卷 1037-1047页

作者： Pedro Pimentel-Nunes Joao Bruno Soares mário dinis-ribeiro Department of Physiology Cardiovascular Research&Development UnitFaculty of MedicineUniversity of PortoPortoPortugal Gastroenterology Department Portuguese Oncology InstitutePortoPortugal Gastroenterology Department Hospital de BragaBragaPortugal CIDES/CINTESIS Faculty of MedicineUniversity of PortoPortoPortugal

Toll-like receptors (TLR) are essential for Helicobacter pylori (Hp) recognition and subsequent innate and adaptive immunity responses. TLR2 appears to be the receptor responsible for most of the immunologic reaction against Hp infection. However, TLR4, TLR9 and eventually TLR5 may also have a synergic effect with TLR2 against Hp. It has been shown that gastric Hp infection increases TLR expression in the gastric mucosa. moreover, recent studies have shown that human gastric carcinogenesis is associated not only with increased expression of TLR but also with decreased expression of their inhibitors such as Toll-Interacting Protein (TOLLIP) and peroxisome proliferator-activated receptor (PPAR)-g. Indeed, gastric dysplasia and adenocarcinoma are associated with high expression levels of TLR and low levels of TOLLIP and PPAR-g, suggesting increased activation of these receptors throughout human gastric carcinogenesis. In this article we discuss how these novels findings could be used not only for the diagnosis and prognosis of gastric lesions associated with Hp infection but also for their treatment. Specifically, we discuss the potential use of TLR agonists in addition to antibiotics to improve eradication rates of Hp and of TLR antagonists to slow the progression of gastric preneoplastic lesions. We also discuss the potential value of TLR signalling blockers and quantification of tumoral TLR expression, respectively, in the treatment and prognosis of gastric cancer. In conclusion, TLRs can be an important link between Hp and the sequence of gastric carcinogenesis and they can be used as biomarkers of gastric carcinogenesis. In this article, future lines of investigation related with these novel scientific findings are proposed and discussed.

关键词： Toll-Like Receptors Gastric Cancer TOLLIP Carcinogenesis Helicobacter pylori

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Gastric cancer in a Caucasian population: Role of pepsinogen C genetic variants

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World Journal of Gastroenterology 2006年第31期12卷 5033-5036页

作者： Ana L Pinto-Correia Hugo Sousa maria Fragoso Luís moreira-Dias Carlos Lopes Rui medeiros mário dinis-ribeiro molecular Oncology GroupPortuguese Institute of Oncology of Porto Portugal Oncology DepartmentPortuguese Institute of Oncology of Porto Portugal Gastroenterology DepartmentPortuguese Institute of Oncology of Porto Portugal and ICBAS Abel Salazar Institute for the Biomedical SciencesPortoPortugal and CINTESIS/Faculty of medicine University of Porto PortoPortugal

瞄准：在胃蛋白酶原 C (PGC ) 基因学习插入 / 删除多型性的角色，为胃粘膜的终端区别的一个有效标记，在到胃的损害的开发的危险性。方法：没有肿瘤的疾病的证据，学习与已知的胃的损害的 99 件样品和 127 件样品被执行。PCR 被采用，... 详细信息

瞄准：在胃蛋白酶原 C (PGC ) 基因学习插入 / 删除多型性的角色，为胃粘膜的终端区别的一个有效标记，在到胃的损害的开发的危险性。方法：没有肿瘤的疾病的证据，学习与已知的胃的损害的 99 件样品和 127 件样品被执行。PCR 被采用， 6 多态的等位基因被放大：等位基因 1 (510 bp ) ，等位基因 2 (480 bp ) ，等位基因 3/4 (450/460 bp ) ，等位基因 5 (400 bp ) 并且等位基因 6 (310 bp ) 。结果：我们的结果表明等位基因 6 搬运人似乎对任何胃的损害的发展有保护(或 = 0.34；P<0.001 ) ，与象萎缩或肠的组织变形那样的胃的腺癌联系的 non-dysplastic 损害(或 = 0.28；P<0.001 ) 或侵略 GC (或 = 0.39；P = 0.004 ) 。结论：我们的学习表明等位基因 6 搬运人地位在胃的损害的发展有一个保护的角色，可能由于它有 PGC 的更高的表示的协会。而且，在控制组的等位基因 6 搬运人的频率比在亚洲人口获得了高是远的，它可能代表在白种人和亚洲人口之间的基因差距。

关键词：胃癌胃蛋白酶原遗传疾病病理机制

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-765G > C COX-2 polymorphism may be a susceptibility marker for gastric adenocarcinoma in patients with atrophy or intestinal metaplasia

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World Journal of Gastroenterology 2006年第34期12卷 5473-5478页

作者： Carina Pereira Hugo Sousa Paula Ferreira maria Fragoso Luís moreira-Dias Carlos Lopes Rui medeiros mário dinis-ribeiro molecular Oncology Group Portuguese Institute of Oncology of Porto Portugal and ICBAS Abel Salazar Institute for the Biomedical Sciences Porto Portugal Oncology Department Portuguese Institute of Oncology of Porto Portugal Gastroenterology Department Portuguese Institute of Oncology of Porto Portugal and Cintesis / Faculty of medicine University of Porto Porto Portugal

AIm: To investigate the relationship between the -765G > C COX-2 polymorphism and the development of different gastric lesions: atrophy or intestinal metaplasia and gastric adenocarcinoma. mETHODS: A cross-sectional study was performed involving 320 Portuguese individuals (210 without evidence of neoplastic disease, 73 patients with gastric adenocarcinomas and 37 with atrophy or intestinal metaplasia) using a PCR-RFLP method. RESULTS: -765C allele was overrepresented in the patients with gastric adenocarcinoma (51%) when compared either with the control group (38%) or patients with atrophy or intestinal metaplasia (27%). Callele was found to be very common in our population (0.22), and a multivariate logistic regression analysis revealed nearly 3-fold increased risk for the progression to gastric adenocarcinoma in patients with atrophy or intestinal metaplasia carrying the -765C allele (OR = 2.67, 95% CI = 1.03-6.93; P = 0.04).considered as another susceptibility marker for gastric adenocarcinoma development in patients with atrophy or intestinal metaplasia.

关键词：基因多态性易感性胃癌肠生化

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Web-based system for training and dissemination of a magnification chromoendoscopy classification

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世界胃肠病学杂志：英文版 2008年第46期14卷 7086-7092页

作者： mário Jorge dinis-ribeiro Ricardo Cruz Correia Cristina Santos Sónia Fernandes Ernesto Palhares Rui Almeida Silva Pedro Amaro miguel Areia Altamiro Costa-Pereira Luis moreira-Dias Gastroenterology Department Portuguese Oncology Institute Center for Research in Information Systems and Health Technologies (CINTESIS)/Department of Biostatistics and medical Informatics Porto Faculty of Medicine Gastroenterology Department Coimbra University Hospital

AIm:To evaluate the use of web-based technologies to assess the learning curve and reassess reproducibility of a simplified version of a classification for gastric magnification chromoendoscopy (mC). mETHODS: As part of a multicenter trial, a hybrid approach was taken using a CD-ROm, with 20 films of mC lasting 5 s each and an "autorun" file triggering a local HTmL frameset referenced to a remote questionnaire through an Internet connection. Three endoscopists were asked to prospectively and independently classify 10 of these films randomly selected with at least 3 d apart. The answers were centrally stored and returned to participants together with adequate feedback with the right answer. RESULTS: For classification in 3 groups, both intra- [Cohen's kappa (κ) = 0.79-1.00 to 0.89-1.00] and inter-observer agreement increased from 1st (moderate) to 6th observation (κ = 0.94). Also, agreement with reference increased in the last observations (0.90, 1.00 and 1.00, for observers A, B and C, respectively). Validity of 100% was obtained by all observers at their 4th observation. When a 4th (sub)group was considered, inter-observer agreement was almost perfect (κ=0.92) at 6th observation. The relation with reference clearly improved into κ (0.93-1.00) and sensitivity (75%-100%) at their 6th observations. CONCLUSION: This mC classification seems to be easily explainable and learnable as shown by excellent intra-and inter-observer agreement, and improved agreement with reference. A web system such as the one used in this study may be useful for endoscopic or other image based diagnostic procedures with respect to definition, education and dissemination.

关键词：色原体再现性学习曲线性临床医学胃镜检查

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One image is worth more than a thousand words:producing an atlas of medical signs for teaching clinical and forensic toxicology

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Forensic Sciences Research 2022年第4期7卷 815-822页

作者： Ricardo Jorge dinis-Oliveira TOXRUN-Toxicology Research Unit University Institute of Health SciencesAdvanced Polytechnic and University Cooperative(CESPU)CRLGandraPortugal Department of Public Health and Forensic Sciences and Medical EducationFaculty of MedicineUniversity of PortoPortoPortugal UCIBIO-REQUImTE Laboratory of ToxicologyDepartment of Biological SciencesFaculty of PharmacyUniversity of PortoPortoPortugal

Clinical and forensic toxicology are critically involved in the acquisition of basic skills to correctly suspect intoxication,collect biological and non-biological materials for toxicological analysis,comprehend the complexities inherent to laboratory activity,and understand the fundamentals of toxicokinetics and toxicodynamics that underlie the interpretation of results.This works presents a pedagogical innovation proposal for the teaching of clinical and forensic toxicology based on a compilation of more than 3000 cases where the image was fulcra for suspicion.The experience in this article follows the model practiced in bachelors,masters,and PhD degrees,as well as in other continuing training courses,where we are teaching toxicology for more than 15 years.All these levels of education are considered fundamental to the sound development of this science.This approach aims also to offer strength to the intervention of the true toxicologist in all the toxicological phases,besides the classic analytical chemistry.Indeed,it is impossible to provide effective clinical and forensic toxicological interpretations without a proper and broad education,and not thinking exclusively in terms of laboratory techniques.In the future,it will be interesting to evaluate knowledge retention and to propose a database of videos of signs related to intoxications.

关键词： Forensic sciences clinical and forensic toxicology teaching learning signs of exposure pre-analytical phase

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Biomarkers of hypoxic-ischemic encephalopathy:a systematic review

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World Journal of Pediatrics 2023年第6期19卷 505-548页

作者： Ines Caramelo margarida Coelho miguel Rosado Carla m.P.Cardoso Alexandra dinis Carlos B.Duarte mario Graos Bruno manadas CNC-Center for Neuroscience and Cell Biology University of Coimbra3004‑504 CoimbraPortugal PhD Programme in Experimental Biology and Biomedicine Institute for Interdisciplinary Research(IIIUC)University of CoimbraCasa Costa Alemão3030‑789 CoimbraPortugal Chemistry Department Faculty of Sciences and TechnologyUniversity of Coimbra3004‑535 CoimbraPortugal Stemlab SA 3060‑197 CantanhedePortugal Pediatric Intensive Care Unit Hospital PediátricoCentro Hospitalar E Universitário de Coimbra3000‑075 CoimbraPortugal Department of Life Sciences University of Coimbra3001‑401 CoimbraPortugal Biocant Technology Transfer Association3060‑197 CantanhedePortugal Institute for Interdisciplinary Research University of Coimbra(IIIUC)3030‑789 CoimbraPortugal

Background Current diagnostic criteria for hypoxic–ischemic encephalopathy in the early hours lack objective measurement tools.Therefore,this systematic review aims to identify putative molecules that can be used in diagnosis in daily clinical practice(PROSPERO ID:CRD42021272610).Data sources Searches were performed in Pubmed,Web of Science,and Science Direct databases until November 2020.English original papers analyzing samples from newborns>36 weeks that met at least two American College of Obstetricians and Gynecologists diagnostic criteria and/or imaging evidence of cerebral damage were included.Bias was assessed by the Newcastle–Ottawa Scale.The search and data extraction were verified by two authors separately.Results From 373 papers,30 met the inclusion criteria.Data from samples collected in the first 72 hours were extracted,and increased serum levels of neuron-specific enolase and S100-calcium-binding protein-B were associated with a worse prognosis in newborns that suffered an episode of perinatal asphyxia.In addition,the levels of glial fibrillary acidic protein,ubiquitin carboxyl terminal hydrolase isozyme-L1,glutamic pyruvic transaminase-2,lactate,and glucose were elevated in newborns diagnosed with hypoxic–ischemic encephalopathy.moreover,pathway analysis revealed insulin-like growth factor signaling and alanine,aspartate and glutamate metabolism to be involved in the early molecular response to insult.Conclusions Neuron-specific enolase and S100-calcium-binding protein-B are potential biomarkers,since they are correlated with an unfavorable outcome of hypoxic-ischemic encephalopathy newborns.However,more studies are required to determine the sensitivity and specificity of this approach to be validated for clinical practice.

关键词： Biomarker Hypoxic-ischemic encephalopathy Neonatal brain injury Newborn Neuron-specific enolase S100-calcium-binding protein-B

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Predatory journals and meetings in forensic sciences:what every expert needs to know about this“parasitic”publishing model

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Forensic Sciences Research 2021年第3期6卷 303-309页

作者： Ricardo Jorge dinis-Oliveira ToXrUn-Toxicology research Unit University institute of health sciences(iUc)CESPUCRLGandraPortugal Department of Public health and Forensic sciences and Medical educationFaculty of MedicineUniversity of PortoPortoPortugal UCIBIO REQUIMETLaboratory of ToxicologyDepartment of Biological sciencesFaculty of PharmacyUniversity of PortoPortoPortugal

The emergence of the internet has transformed all areas of society.This includes the universe of scientific publications,with several publishers now exclusively focusing on the electronic format and open access model while expanding to a megajournal scope.in this context,the pandemic of predatory open access journals(POAJs)and meetings are of grave concern to the academic and research community.This new shift within academia produces a variety of new victims;namely,the authors themselves.in turn,scientific knowledge is often discredited,with the public placing less trust in science.Now more than ever,performing research with integrity and selecting a journal in which to publish requires close attention and expertise.The“predatory movement”has developed increasingly sophisticated techniques for misleading people into believing what seem to be credible professional layouts and legitimate invitations.initiatives such as the Jeffrey Beall’s list,the Cabell’s Scholarly Analytics and Think.Check.Submit offer some guidance to uncover the“parasitic”intervention of predatory journals and meetings,but specific education in this field is sorely needed.This work aims to review the main characteristics of predatory journals and meetings and to analyze this topic in the context of forensic and legal medicine research.

关键词： Forensic sciences predatory open access journals predatory meetings Jeffrey Beall’s list research integrity peer review scientific publishing

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