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Factors predicting poor prognosis in ischemic colitis

World Journal of Gastroenterology 2006年第30期12卷 4875-4878页

作者： Ramón A■ón marta maia boscá Vicente Sanchiz Joan Tosca Pedro Almela Cirilo Amorós Adolfo Benages Department of Gastroenterology of the University Clinical Hospital of Valencia University of Valencia Spain

AIM： To determine the clinical, analytical and endoscopic factors related to ischemic colitis （IC） severity. METHODS： A total of 85 patients were enrolled in a retrospective study from January 1996 to May 2004. There were 53 females and 32 males （age 74.6 ± 9.4 years, range 45-89 years）. The patients were diagnosed as IC. The following variables were analyzed including age, sex, period of time from the appearance of symptoms to admission, medical history, medication, stool frequency, clinical symptoms and signs, blood tests （hemogram and basic biochemical profile）, and endoscopic findings. Patients were divided in mild IC group and severe IC group （surgery and/or death）. Qualitative variables were analyzed using chi-square test and parametric data were analyzed using Student＇s t test （P 〈 0.05）. RESULTS： The mild IC group was consisted of 69 patients （42 females and 27 males, average age 74.7 ± 12.4 years）. The severe IC group was composed of 16 patients （11 females and 5 males, average age of 73.8 ± 12.4 years）. One patient died because of failure of medical treatment （no surgery）, 15 patients underwent surgery （6 after endoscopic diagnosis and 9 after peroperatory diagnosis）. Eight of 85 patients （9.6%） died and the others were followed up as out-patients for 9.6 ± 3.5 mo. Demographic data, medical history, medication and stool frequency were similar in both groups （P 〉 0.05）. Seriously ill patients had less hematochezia than slightly ill patients （37.5% vs 86.9%, P = 0.000）. More tachycardia （45.4% vs 10.1%, P = 0.011） and a higher prevalence of peritonism signs （75% vs 5.7%, P = 0.000） were observed in the severe IC group while the presence and intensity of abdominal pain were similar between two groups. Two patients with severe IC had shock when admitted. Regarding analytical data, more seriously ill patients were found to have anemia and hyponatremia than the mildly ill patients （37.5% vs 10.1%, P = 0.014 and 46.6% vs 14.9%, P = 0.012, respectively）. Steno

关键词： Ischemic colitis Hematochezia Tachycardia Peritonism Anemia Hyponatremi Stenosis

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Methotrexate induced sprue-like syndrome

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World Journal of Gastroenterology 2008年第45期14卷 7009-7011页

作者： marta maia boscá Ramon Aón Rosana Villagrasa Nelly Balza Cirilo Amorós Adolfo Benages Empar Mayordomo Juan Ramon Corts Gastroenterology Department Hospital Clínic Universitari of València Department of Anathomo-Pathology Hospital Clínic Universitari of València Rheumatology Department Hospital Clínic Universitari of València

A 52 year-old male patient diagnosed of ankylosing spon-dylitis presented with an iron deficiency anemia after a ten-month treatment of methotrexate. He did not respond to treatment with oral iron not a proton pump inhibitor and an upper endoscopy was performed. The histological study of the duodenal biopsies showed villus atrophy. After removing the methotrexate, administrating intra-muscular iron and undertaking a gluten-free diet, the histological and analytical alterations progressively resolved.

关键词： Methotrexate Villous atrophy Iron deficiency anemia Paucisymptomatic Absence of celiac antibodies

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The Role of Surgery in Primary Thyroid Lymphoma: Experience in the Last 10 Years of a Specialized Unit

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Journal of Cancer Therapy 2016年第13期7卷 1059-1070页

作者： Raquel Alfonso-Ballester María José Terol Castera Omar García Rodríguez Carolina Martínez Ciarpaglini marta maia boscá-Watts Norberto Cassinello Fernández Joaquín Ortega Serrano Departments of Surgery (Endocrine Section) University Clinic Hospital of Valencia Valencia Spain Departments of Medical Oncology University Clinic Hospital of Valencia Valencia Spain Departments of Oral and Maxillofacial Surgery University Clinic Hospital of Valencia Valencia Spain Departments of Pathology University Clinic Hospital of Valencia Valencia Spain Departments of Digestive Medicine University Clinic Hospital of Valencia Valencia Spain

Primary Thyroid Lymphoma (PTL) is an uncommon disease, although its incidence is of 5%. Ultrasound and Fine Needle Aspiration Cytology (FNAC) usually do not provide the diagnosis. Surgery is one of the treatment options because it enables histological diagnosis and can also relieve compression symptoms in patients with rapid growth cervical mass. We present 7 cases of PTL diagnosed in the last 10 years in our unit. Five were female (71.4%) and 2 were male (28.6%). The mean age was 64.2 (range: 40 - 81);4 patients (57.1%) had associated Hashimoto’s Thyroiditis (HT). One patient (14.2%) had concomitant Graves disease. 5 cases presented with compressive symptoms and cervical mass. Ultrasound was not diagnostic in any case. FNAC was diagnostic only in one patient (14.3%). Five patients underwent total thyroidectomy (71.4%). All the cases were diagnosed with lymphoma postoperatively. Two interventions consisted of left hemithyroidectomies (28.6%). No complications appeared. 5 patients (71.4%) were classified as Mucosa-Associated Lymphoid Tissue (MALT) lymphoma. We also observed 1 Follicular grade I lymphoma and 1 Burkitt case. When the extension study was done, 1 patient was at stage IIIE (14%), 2 at IIE (28.5%) and 4 at IE (57.14%). Rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone (R-CHOP) and Iphosphamide, ethoposide and high dose Cytarabine (IVAC) were the treatment scheme when chemotherapy was used (in three cases). Two cases were treated only with total thyroidectomy, and 2 with total thyroidectomy and rituximab, and the latter was MALT. Complete Remission (CR) was achieved in all patients in the first year. All are still alive and in CR. In our experience, PTL diagnose can be challenging before surgery. Although surgery is not the gold standard for treatment, when it is done, it should be curative in MALT lymphomas confined to the thyroid.

关键词： Thyroid Lymphoma Thyroidectomy Endocrine Surgery Extranodal Lymphoma Malt Lymphoma Rituximab

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HLA-DQ:Celiac disease vs inflammatory bowel disease

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World Journal of Gastroenterology 2018年第1期24卷 96-103页

作者： marta maia bosca-Watts Miguel Minguez Dolores Planelles Samuel Navarro Alejandro Rodriguez Jesus Santiago Joan Tosca Francisco Mora Disease Department of the University Clinic Hospital of Valencia University of ValenciaValencia 46017Spain Histocompatibility Department of the Transfusion Center of the Valencian Community Valencia 46014Spain Pathology Department of the University Clinic Hospital of Valencia University of ValenciaValencia 46017Spain Digestive Disease Department of the Hospital Virgen del Castillo of Yecla Yecla 30510Spain Digestive Disease Department of the Hospital de Manises Valencia 46940Spain Digestive Disease Department of the University Clinic Hospital of Valencia University of ValenciaValencia 46017Spain

AIM To determine the genetic predisposition to celiacdisease(Ce D) in inflammatory bowel disease(IBD) patients by quantifying the frequency of Ce D-related human leucocyte antigen(HLA)(HLA-Ce D: HLA-DQ2 and-DQ8) in IBD patients globally, by type of IBD and gender, and by calculating the protective/risk contribution of these haplotypes in the development of the IBD *** We conducted a prospective study with IBD patients from our Unit. Clinical information was gathered and blood was tested for HLA-CeD. The control group was made up of unrelated Valencian organ ***1034 subjects were analyzed: 457 IBD [207 ulcerative coliti(UC) and 250 Crohn's disease(CD)] patients and 577 healthy controls. 39% of the controls and 34% of the patients had HLA-Ce D(P = 0.0852). HLA-DQ2 was less frequent in UC patients(P = 0.0287), and HLA-DQ8 in CD(P = 0.0217). In women with UC, the frequency of DQ2.5 cis(DQB1*02:01-DQA1*05:01) was reduced ≥ 50% [P = 0.0344; preventive fraction(PF) = 13%]. PFs(7%-14%) were obtained with all HLACe D haplotypes. HLA DQB1*02:02-DQA1*02:01(HLADQ2.2) was more frequent in CD patients with respect to controls(P = 0.001) and UC patients(etiological fraction = 15%).CONCLUSION HLA-CeD is not more frequent in IBD patients, with an even lower frequency of HLA-DQ2 and-DQ8 in UC and CD respectively. HLA-DQ2.5 confers protection from the development of UC, especially in women, and HLADQ8 does so for the appearance of CD. HLA-DQ2.2 is present in 34% of the CD patients and may constitute a genetic risk factor for CD development.

关键词： Genetic predisposition Celiac disease Inflammatory bowel disease Crohn's disease Human leucocyte antigen Ulcerative colitis

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Real-world data on the infliximab biosimilar CT-P13 (Remsima®) in inflammatory bowel disease

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World Journal of Clinical Cases 2021年第36期9卷 11285-11299页

作者： Jose María Huguet Xavier Cortés marta maia bosca-Watts Marian Aguas Nuria Maroto Lidia Martí Cirilo Amorós Jose María Paredes Department of Gastroenterology General University Hospital of ValenciaValencia 46014Spain Department of Gastroenterology Hospital de SaguntoSagunto 46520Spain Department of Gastroenterology Hospital Clinico Universitario de ValenciaValencia 46010Spain Department of Gastroenterology Hospital Universitario y Politecnico la Fe de ValenciaValencia 46026Spain Department of Gastroenterology Hospital de ManisesManises 46940Spain Department of Gastroenterology Hospital Comarcal Francesc de BorjaGandia 46702Spain Department of Gastroenterology Hospital Arnau de Vilanova de ValenciaValencia 46015Spain Department of Gastroenterology Hospital Universitario Doctor Peset de ValenciaValencia 46017Spain

BACKGROUND In recent years,biological therapies have revolutionized the management of inflammatory bowel disease(IBD);however,they are *** development of biosimilar products has allowed us to reduce healthcare costs and improve patients’access to these *** various studies support the similarity between infliximab and its biosimilar CT-P13 in terms of efficacy and safety,there are unmet needs regarding research on these agents in the context of *** To analyze clinical response rates to CT-P13 and adverse events in IBD patients treated in real-life *** An observational,prospective,multicenter study of IBD patients treated with CTP13 in clinical practice who were naïve to biological treatments or failed to respond to other anti-tumor necrosis factor drugs or had switched from infliximab originator was carried *** diagnostic or follow-up interventions were conducted on patients outside usual clinical *** primary endpoints were clinical response rates and number of adverse *** primary efficacy variable was the proportion of patients who were in clinical remission and/or had a clinical response at 3,6,9,and 12 *** A total of 220 IBD patients treated with CT-P13(Remsima®)were included in the study:87(40%)with ulcerative colitis and 133(60%)with Crohn’s *** age of the patients was 41.47(SD 15.74)years,and 58%were ***(9%)patients started treatment with CT-P13 after switching from *** the remaining 201 patients,142(65%)were naïve to biologic *** baseline,68.6%(n=138/201)of patients presented with active *** 12 mo of treatment,14.8%(n=12/81)presented with active disease,and 64.2%(n=52/81)were in clinical remission without *** 3 mo,75.5%(n=115/152)had a clinical response or achieved clinical remission,which was sustained for 12 mo(85.2%;n=69/81).There was a decrease in specific IBD indices at 3,6,9,and 12 mo(P<0.001).A total of 34 adverse events

关键词： Crohn’s disease Ulcerative colitis Inflammatory bowel disease Infliximab Biosimilar CT-P13

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Short-term effectiveness of golimumab for ulcerative colitis: Observational multicenter study

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World Journal of Gastroenterology 2016年第47期22卷 10432-10439页

作者： marta maia bosca-Watts Xavier Cortes Marisa Iborra Jose Maria Huguet Laura Sempere Gloria Garcia Rafa Gil Mari Fe Garcia Marga Munoz Pedro Almela Nuria Maroto Jose Maria Paredes Inflammatory Bowel Disease Unit Digestive Disease DepartmentUniversity of ValenciaUniversity Clinic Hospital of Valencia46010 ValenceiaSpain Digestive Disease Department Hospital of Sagunto46010 ValenciaSpain Gastroenterology Department and CIBEREHD Hospital Universitari i Politecnic La Fe46026 ValenciaSpain Digestive Disease Department General Hospital of Valencia46014 ValenciaSpain Digestive Disease Department General Hospital of Alicante03010 AlacantSpain Digestive Disease Department San Juan University Hospital of Alicante46015 ValenciaSpain Digestive Disease Department Arnau Hospital of Valencia Digestive Disease Department General University Hospital of Elche03203 AlicaneSpain Digestive Disease Department General Hospital of Castellon12004 Castellón de la PlanaSpain Digestive Disease Department Hospital of Manises46940 ManisesSpain Digestive Disease Department Peset University Hospital of Valencia46017 ValenciaSpain

AIM To evaluate the real-world effectiveness of golimumab in ulcerative colitis(UC) and to identify predictors of *** We conducted an observational, prospective and multi-center study in UC patients treated with golimumab, from September 2014 to September 2015. Clinical activity was assessed at wk 0 and 14 with the physician's global clinical assessment(PGA) and the partial Mayo score. Colonoscopies and blood tests were performed, following daily-practice clinical criteria, and the results were recorded in an SPSS *** Thirty-three consecutive patients with moderately to severely active UC were included. Among them, 54.5% were female and 42 years was the average age. Thirty percent had left-sided UC(E2) and 70% had extensive UC(E3). All patients had an endoscopic Mayo score of 2 or 3 at baseline. Twenty-seven point three percent were anti-tumor necrosis factor(TNF) treatment na?ve, whereas 72.7% had previously received infliximab and/or adalimumab. Sixty-nine point seven percent showed clinical response and were steroid-free at wk 14(a decrease from baseline in the partial Mayo score of at least 3 points). Based on PGA, the clinical remission and clinical response rates were 24% and 55% respectively. Withdrawal of corticosteroids was observed in 70.8% of steroid-dependent patients at the end of the study. Three out of 10 clinical non-responders needed a colectomy. Mean fecal calprotectin value at baseline was 300 μg/g, and 170.5 μg/g at wk 14. Being anti-TNF treatment na?ve was a protection factor, which was related to better chances of reaching clinical remission. Twenty-seven point three percent of the patients required treatment intensification at 14 wk of followup. Only three adverse effects(AEs) were observed during the study; all were mild and golimumab was not *** This real-life practice study endorses golimumab's promising results, demonstrating its short-term effectiveness and confirming it as a safe drug during t

关键词： Golimumab Ulcerative colitis Real-life results

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Phytochemical Analysis and Antifungal Activity of Extracts from Leaves and Fruit Residues of Brazilian Savanna Plants Aiming Its Use as Safe Fungicides

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Natural Products and Bioprospecting 2016年第4期6卷 195-204页

作者： Caroline Alves Breda Alessandra Marcon Gasperini Vera Lucia Garcia Karin maia Monteiro Giovana Anceski Bataglion Marcos Nogueira Eberlin marta Cristina Teixeira Duarte School of Food Engineering State University of CampinasUNICAMPMonteiro Lobato Street80BaraōGeraldoCampinasSaōPaulo 13083-862Brazil Microbiology Division of Research Center for Chemistry Biology and Agriculture–CPQBAUniversity of CampinasUNICAMPAlexandre Cazelatto Street999BetelPaulı´niaSaöPaulo 13148-218Brazil Organic Chemistry and Pharmaceutical Division of Research Center for Chemistry Biology and Agriculture–CPQBAUniversity of CampinasUNICAMPAlexandre Cazelatto Street999BetelPaulíniaSaöPaulo 13148-218Brazil Pharmacology and Toxicology Division of Research Center for Chemistry Biology and Agriculture–CPQBAUniversity of CampinasUNICAMPAlexandre Cazelatto Street999BetelPaulíniaSaöPaulo 13148-218Brazil ThoMSon Mass Spectrometry Laboratory Institute of ChemistryState University of CampinasUNICAMPCampinasSaōPaulo 13084-971Brazil

The increasing demand for safe food without preservatives or pesticides residues has encouraged several studies on natural products with antifungal activity and low *** this study,ethanolic extracts from leaves and fruit residues(peel and seeds)of three Brazilian savanna species(Acrocomia aculeata,Campomanesia adamantium and Caryocar brasiliense)were evaluated against phytopathogenic ***,the most active extract was chemically characterized by ESI-MS and its oral acute toxicity was *** from ***(pequi)peel and leaves were active against Alternaria alternata,Alternaria solani and Venturia pirina with minimal inhibitory concentrations between 350 and 1000 lg/*** incorporated in solid media,these extracts extended the lag phase of *** and *** and reduced the growth rate of *** peel extract showed better antifungal activity and their ESI-MS analysis revealed the presence of substances widely reported as antifungal such as gallic acid,quinic acid,ellagic acid,glucogalin and *** oral acute toxicity was relatively low,being considered safe for use as a potential natural fungicide.

关键词： Brazilian savanna fruits Residues Natural fungicides Phytopathogens

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Pathogenesis of Crohn's disease: Bug or no bug

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World Journal of Gastrointestinal Pathophysiology 2015年第1期6卷 1-12页

作者： marta maia bosca-Watts Joan Tosca Rosario Anton Maria Mora Miguel Minguez Francisco Mora IBD Unit Digestive Disease DepartmentUniversity of ValenciaUniversity Clinic Hospital of Valencia and INCLIVA Health Research Institute

The possibility of an infectious origin in inflammatory bowel disease(IBD)has been postulated since the first description of Crohn’s disease(CD).Many observations implicate bacteria as a trigger for the development of CD:lesions occur in regions with higher bacterial concentrations;aphthous ulcers occur in Peyer’s patches;inflammation resolves when the fecal stream is diverted and is reactivated following reinfusion ofbowel contents;severity of the disease is correlated with bacterial density in the mucosa;granulomas can contain bacteria;and susceptible mice raised in germfree conditions develop inflammation when bacteria are introduced in the 1990’s,several studies sought to establish a relationship with viral infections and the onset of IBD,finally concluding that no direct link had been *** the past fifteen years,evidence relating IBD pathogenesis to Mycobacterium avium paratuberculosis,salmonella,campylobacter,etc.,has been *** tendency now under discussion to regard microbiota as the primary catalyst has led to the latest studies on microbiota as pathogens,focusing on Escherichia coli,mainly in ileal *** present review discusses the literature available on these"bugs".

关键词： Inflammatory bowel disease Crohn’s dise-ase Ulcerative colitis Bacteria Virus Pathogenesis

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Neurological and behavioral manifestations of cerebral malaria:An update

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World Journal of Translational Medicine 2014年第1期3卷 9-16页

作者： marta Chagas Monteiro Fabio Rodrigues Oliveira Gedeo Batista Oliveira Pedro Roosevelt Torres Romo Cristiane Socorro Ferraz maia Programa de Pós-Gradua??o em Ciências Farmacêuticas Instituto de Ciências da Sau?deUniversidade Federal do ParáRua Augusto CorrêaCampus Universitário do GuamáBelémPA 66075900Brazil Program in Pharmaceutical Sciences Faculty of Pharmacy Laboratory of inflammation and behavior Federal University of Pará/UFPABelémPA 66075900Brazil Programa de Pós-Gradua??o em Ciências da Saúde Universidade Federal de Ciências da Saúde de Porto AlegrePorto AlegreRS 90050170 Brazil

Neglected tropical diseases are a group of tropical diseases endemic in poor countries even though medical treatment and cures are available. They are considered a global health problem due to the severity of the physiological changes they induce in their hosts. Malaria is a disease caused by Plasmodium sp. that in its cerebral form may lead to acute or long-term neurological deficits, even with effective antimalarial therapy, causing vascular obstruction, reduced cerebral blood flow and many other changes. However, Plasmodium falciparum infection can also develop into a cerebral malaria(CM) disease that can produce neurological damage. This review will discuss the mechanisms involved in the neuropathology caused by CM, focusing on alterations in cognitive, behavior and neurological functions in human and experimental models.

关键词： Malaria Cerebral malaria Neuropathology Plasmodium sp Plasmodium falciparum

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National prevalence and risk factors for tungiasis in Kenya

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Infectious Diseases of Poverty 2023年第5期12卷 97-97页

作者： Lynne Elson Christopher Kamau Sammy Koech Christopher Muthama George Gachomba Erastus Sinoti Elwyn Chondo Eliud Mburu Miriam Wakio Jimmy Lore marta maia Ifedayo Adetifa Benedict Orindi Phillip Bejon Ulrike Fillinger Kenya Medical Research Institute-Wellcome Trust Research Programme Kilifi Kenya Nuffield Department of Medicine University of Oxford Oxford UK Department of Health Muranga Kenya Department of Health Kericho Kenya Department of Health Makueni Kenya Department of Health Nakuru Kenya Department of Health Samburu Kenya Department of Health Kilifi Kenya Department of Health Kajiado Kenya Department of Health Taita Taveta Kenya Department of Health Turkana Kenya London School of Hygiene and Tropical Medicine London UK International Centre for Insect Physiology and Ecology (Icipe) Nairobi Kenya

Background Tungiasis is a highly neglected tropical skin disease caused by the sand flea,Tunga penetrans,the female of which burrows into the skin,causing pain and *** disease occurs throughout South America and sub-Saharan Africa but there are few systematic data on national disease *** tungiasis research community is keen to develop survey methods to fill this *** we used a school-based,thorough examination method to determine the prevalence and risk factors for tungiasis in *** We conducted the first nationally representative survey of tungiasis,including nine counties covering the major ecological zones of Kenya.A stratified multistage random sampling was used to select 22 primary schools from each of the nine counties and to select up to 114 pupils aged 8 to 14 years in each *** were examined thoroughly for *** surveys were conducted,the first between May and July 2021 and the second between October 2021 and April 2023 when pupils were also interviewed for risk *** effect logistic regression models were used to test associations of independent variables with tungiasis using the school as a random *** The overall prevalence of tungiasis in the first survey was 1.35%[95%confidence interval(CI):1.15-1.59%],and 0.89%in the second *** prevalence ranged from 0.08%(95%CI:0.01-0.59%)in Taita Taveta county to 3.24%(95%CI:2.35-4.44%)in Kajiado *** infection was associated with county of residence,male sex[adjusted odds ratio(aOR)=2.01,95%CI:1.52-2.67],and lower age(aOR=0.81,95%CI:0.75-0.88).For the first time we demonstrate an association with attending public schools rather than private schools(aOR=5.62,95%CI:1.20-26.22)and lower socioeconomic status(aOR=0.10,95%CI:0.03-0.33).Using a rapid screening method of the top of feet only,would have missed 62.9%of all cases,78.9%of mild cases and 20.0%of severe *** Tungiasis is widely but heterogeneously distributed across K

关键词： Tungiasis Neglected tropical diseases Prevalence Disease burden Kenya

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