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

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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

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 ***,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 *** 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 *** was assessed by the Newcastle–Ottawa *** search and data extraction were verified by two authors *** From 373 papers,30 met the inclusion *** 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 *** 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 ***,pathway analysis revealed insulin-like growth factor signaling and alanine,aspartate and glutamate metabolism to be involved in the early molecular response to *** Neuron-specific enolase and S100-calcium-binding protein-B are potential biomarkers,since they are correlated with an unfavorable outcome of hypoxic-ischemic encephalopathy ***,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

Analysis of the testimonial evidence of portugal's first major forensic case:part Ⅱ

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Forensic Sciences Research 2020年第4期5卷 266-285页

作者： Ricardo Jorge dinis-Oliveira Department of public Health and Forensic Sciences and Medical EducationFaculty of MedicineUniversity of PortoPortoPortugal IINFACTS-Institute of Research and Advanced Training in Health Sciences and Technologies Department of SciencesUniversity Institute of Health Sciences(IUCS)Advanced Polytechnic and University Cooperative(CESPU)CRLGandraPortugal UCIBIO-REQUImTE Laboratory of Toxicology

The crime possibly perpetrated by a doctor named Vicente Urbino de Freitas in 1890 is one of the most famous cases of poisoning,and it had echoes in the portuguese and foreign press for several *** prestigious doctor was convicted of the fatal poisoning of his *** also attempted the homicide of two nieces and their mother-in-law,who only escaped because they obstinately refused to comply with the"therapeutics"prescribed by the family *** motive of the crime should have been Vicente Urbino de Freitas'ambition to receive the family inheritance of his wife,the daughter of the well-known mer-chant Jose Antonio Sampaio of Flores Street in *** Urbino de Freitas was con-victed but doubt about his guilt persists for more than a *** second work aimed to collect and analyse all the relevant and contradictory testimonial evidence of the prosecu-tion and defence *** case represents an odd historical record obtained through more than 12years of research on the first major significant portuguese forensic *** and unprecedented testimonial evidence and photographs were obtained from different countries and then repaired,since these also provide an important historical record of the medical photography.

关键词： History of legal medicine forensic sciences forensic toxicology Vicente Urbino de Freitas mário Guilherme Augusto de Sampaio testimonial evidence Flores Street

Analysis of antisym metric cross-ply laminates using high-order shear deformation theories:a meshless approach

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Acta mechanica Sinica 2020年第5期36卷 1078-1098,I0003页

作者： D.E.S.Rodrigues J.Belinha L.m.J.S.dinis R.m.Natal Jorge Institute of Science and Innovation in mechanical and Industrial Engineering 4200-465 PortoPortugal Department of mechanical Engineering School of EngineeringPolytechnic of Porto(ISEP)4200-072 PortoPortugal Department of mechanical Engineering Faculty of EngineeringUniversity of Porto(FEUP)4200-465 PortoPortugal

For many years finite element method(FEm)was the chosen numerical method for the analysis of composite ***,in the last 20 years,the scientific community has witnessed the birth and development of several meshless methods,which are more flexible and equally accurate numerical *** meshless method used in this work is the natural neighbour radial point interpolation method(NNRpIm).In order to discretize the problem domain,the NNRpIm only requires an unstructured nodal ***,using the Voronoi mathematical concept,it enforces the nodal connectivity and constructs the background integration *** NNRpIm shape functions are constructed using the radial point interpolation *** this work,the displacement field of composite laminated plates is defined by high-order shear deformation *** the end,several antisymmetric cross-ply laminates were analysed and the NNRpIm solutions were compared with the *** obtained results show the efficiency and accuracy of the NNRpIm formulation.

关键词： Antisymmetric cross-ply laminates High-order shear deformation theories meshless methods Naturalneighbour radial point interpolation method(NNRpIm)

Analysis of the autopsy,toxicological,and psychiatric reports of portugal’s first major forensic case:partⅢ

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Forensic Sciences Research 2021年第4期6卷 250-272页

作者： Ricardo Jorge dinis-Oliveira Department of public health and Forensic sciences and Medical educationFaculty of MedicineUniversity of PortoPortoPortugal IINFACTS-Institute of research and advanced Training in health sciences and Technologies Department of sciencesUniversity institute of health sciences(IUCS)advanced Polytechnic and University cooperative(CESPU)CRLGandraPortugal UCIBIO-REQUImTE Laboratory of ToxicologyDepartment of Biological sciencesFaculty of PharmacyUniversity of PortoPortoPortugal

This work presents an odd historical record obtained through more than 14 years of research regarding one of the first major european forensic *** presumed homicide of mário Guilherme Augusto de Sampaio in 1890 was allegedly perpetrated by his uncle,the prestigious doctor vicente Urbino de *** famous poisoning had international repercussions for decades,with the participation of several forensic experts that made the history of forensic sciences,namely forensic toxicology and *** third work aims to collect,restore,and analyse all the forensic evidence,particularly from the autopsy,toxicological,and psychiatric forensic *** regarding the life of vicente Urbino de Freitas during his exile in Brazil were also recovered,along with a vast and outstanding assortment of forensic medicine photographs from the 19th century.

关键词： Forensic sciences forensic reports alkaloids history of legal medicine Flores Street vicente Urbino de Freitas JoséAntónio de Sampaio Junior mário Guilherme Augusto de Sampaio

portugal's first major forensic case and the genesis of forensic toxicology:10 years of research to reconstruct the event

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Forensic Sciences Research 2019年第1期4卷 69-81页

作者： Ricardo Jorge dinis-Oliveira Department of Sciences IINFACTS–Institute of Research and Advanced Training in Health Sciences and TechnologiesUniversity Institute of Health Sciences(IUCS)CESPUCRLGandraPortugal UCIBIO-REQUImTE Laboratory of ToxicologyDepartment of Biological SciencesFaculty of PharmacyUniversity of PortoPortoPortugal Department of public Health and Forensic Sciences and Medical EducationFaculty of MedicineUniversity of PortoPortoPortugal

The"Crime of Flores Street"is one of the most famous cases of poisoning to divide public opinion in portugal in the late 19th century, and it also demonstrated the weaknesses of the portuguese medicolegal system and attested to the importance of toxicological analysis. Vicente Urbino de Freitas was a prominent doctor, graduating from the Faculty of medicine of the University of Coimbra in 1875. He later became professor of physiology at the porto medical-Surgical School and author of a number of books on leprosy. In 1877, he married maria das Dores Basto Sampaio Freitas, and this was followed by the death of a number of her close relatives in suspicious circumstances, notably her brother José António Sampaio Junior and nephew mário Guilherme Augusto de Sampaio. This review aims to retell the story of portugal's first significant medicolegal case as well as the accompanying judicial drama that gave birth to Forensic Toxicology in portugal and prompted the medicolegal organization that exists today. This research was carried out over a 10-year period and repre-sents undeniable historical value given the rarity of the facts compiled. At the heart of this forensic case was the use of toxicological analyses in court for which the Chemist Antònio Joaquim Ferreira da Silva played a key role. This toxicological report revealed high concen-trations of morphine, delphinine and narceine in viscera and in mario's urine. The mario's cause of death was attributed to poisoning by opium alkaloids. Despite the strong judicial evidence, doubts still remains as to whether Vicente Urbino de Freitas was a"monster"or a victim of circumstances and a hapless martyr.

关键词： Forensic sciences forensic toxicology Vicente Urbino de Freitas António Joaquim Ferreira da Silva medical-Surgical School mário Guilherme Augusto de Sampaio

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

-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）.CONCLUSION： -765C carrier status should be considered as another susceptibility marker for gastric adenocarcinoma development in patients with atrophy or intestinal metaplasia.

关键词： Gastric adenocarcinoma Atrophy Intestinal metaplasia COX-2 polymorphism pCR-RFLp pharmacogenomic

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

AIm： To study the role of an insertion/deletion polymorphism in the pepsinogen C （pGC） gene, an effective marker for terminal differentiation of the stomach mucosa, in the susceptibility to the development of gastric lesions. mETHODS： The study was performed with 99 samples of known gastric lesions and 127 samples without evidence of neoplastic disease. pCR was employed and the 6 polymorphic alleles were amplified： Allele 1 （510 bp）, Allele 2 （480 bp）, Allele 3/4 （450/460 bp）, Allele 5 （400 bp） and Allele 6 （310 bp）. RESULTS： Our results revealed that Allele 6 carriers seemed to have protection against the development of any gastric lesion （OR = 0.34; p 〈 0.001）, non-dysplastic lesions associated with gastric adenocarcinoma such as atrophy or intestinal metaplasia （OR = 0.28; p 〈 0.001） or invasive GC （OR = 0.39; p = 0.004）. CONCLUSION： Our study reveals that the Allele 6 carrier status has a protective role in the development of gastric lesions, probably due to its association with higher expression of pGC. moreover, the frequency of Allele 6 carriers in the control group is far higher than that obtained in Asian populations, which might represent a genetic gap between Caucasian and Asian populations.

关键词： Gastric adenocarcinoma pepsinogen C polymorphism