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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

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

New Insights into Aluminum Tolerance in Rice： The ASR5 Protein Binds the STAR1 Promoter and Other Aluminum-Responsive Genes

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Molecular Plant 2014年第4期7卷 709-721页

作者： Rafael Augusto Arenhart Yang Bai Luiz Felipe Valter de Oliveira Lauro Bucker Neto Mariana Schunemann Felipe dos Santos Maraschin Jorge Mariath Adriano Silverio Gilberto Sachetto-Martins rogerio Margis Zhi-Yong Wang Marcia Margis-pinheiro Programa de Pos-Graduacao em Genetica e Biologia Molecular Avenida Bento Goncalves 9500 Departamento de Genetica sala 207 predio 43312 Universidade Federal do Rio Grande do Sul 91501-970 Porto Alegre Brasil Department of Plant Biology Carnegie Institution for Science Stanford CA 94305 USA School of Computer Science and Technology Harbin Institute of Technology Harbin 150001 China Departamento de Botanica Universidade Federal do Rio Grande do Sul Porto Alegre Brasil Departamento de Genetica Universidade Federal do Rio de Janeiro Porto Alegre Brasil Centro de Biotecnologia Universidade Federal do Rio Grande do Sul Porto Alegre Brasil

Aluminum （AI） toxicity in plants is one of the primary constraints in crop production. Al3＋, the most toxic form of Al, is released into soil under acidic conditions and causes extensive damage to plants, especially in the roots. In rice, Al tolerance requires the ASR5 gene, but the molecular function of ASR5 has remained unknown. Here, we perform genome-wide analyses to identify ASR5-dependent Al-responsive genes in rice. Based on ASRS_RNAi silencing in plants, a global transcriptome analysis identified a total of 961 genes that were responsive to Al treatment in wildtype rice roots. Of these genes, 909 did not respond to Al in the ASR5_RNAi plants, indicating a central role for ASR5 in Al-responsive gene expression. Under normal conditions, without Al treatment, the ASR5 RNAi plants expressed 1.756 genes differentially compared to the wild-type plants, and 446 of these genes responded to AI treatment in the wild-type plants. Chromatin immunoprecipitation followed by deep sequencing identified 104 putative target genes that were directly regulated by ASR5 binding to their promoters, including the STAR1 gene, which encodes an ABC transporter required for AI tolerance. Motif analysis of the binding peak sequences revealed the binding motif for ASR5, which was confirmed via in vitro DNA-binding assays using the STAR1 promoter. These results demonstrate that ASR5 acts as a key transcription factor that is essential for AI-responsive gene expression and Al tolerance in rice.

关键词： Aluminum ChlP-Seq RNA-Seq rice ASR.

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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Heart failure as an adverse effect of infliximab for Crohn's disease: A case report and review of the literature

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World Journal of Clinical Cases 2021年第33期9卷 10382-10391页

作者： Thais Gagno Grillo Luciana Rocha Almeida Rodrigo Fedatto Beraldo Mariana Barros Marcondes Diego Aparecido Rios Queiróz Daniel Luiz da Silva Rodrigo Quera Julio pinheiro Baima rogerio Saad-Hossne Ligia Yukie Sassaki Department of Internal Medicine São Paulo State University(Unesp)Medical SchoolBotucatu 18618687São PauloBrazil Department of Pathology São Paulo State University(Unesp)Medical SchoolBotucatu 18618687São PauloBrazil Inflammatory Bowel Disease Program Digestive Disease Center Clínica Universidad de los AndesSantiago 7550000Chile

BACKGROUND Anti-tumor necrosis factor agents were the first biologic therapy approved for the management of Crohn's disease(CD).Heart failure(HF)is a rare but potential adverse effect of these *** objective of this report is to describe a patient with CD who developed HF after the use of *** SUMMARY A 50-year-old woman with a history of hypertension and diabetes presented with abdominal pain,diarrhea,and weight *** and enterotomography showed ulcerations,areas of stenosis and dilation in the terminal ileum,and thickening of the intestinal *** patient underwent ileocolectomy and the surgical specimen confirmed the diagnosis of stenosing *** patient started infliximab and azathioprine treatment to prevent post-surgical *** 6 mo after initiating infliximab therapy,the patient complained of dyspnea,orthopnea,and paroxysmal nocturnal dyspnea that gradually *** revealed biventricular dysfunction,moderate cardiac insufficiency,an ejection fraction of 36%,and moderate pericardial effusion,consistent with *** cardiac disease was considered an infliximab adverse effect and the drug was *** patient received treatment with diuretics for HF and showed improvement of symptoms and cardiac ***,the patient is using anti-interleukin for CD and is *** This reported case supports the need to investigate risk factors for HF in inflammatory bowel disease patients and to consider the risk-benefit of introducing infliximab therapy in such patients presenting with HF risk factors.

关键词： Heart failure Infliximab Anti-tumor necrosis factor therapy Crohn's disease Inflammatory bowel disease Case report

The Impact of an Educational Intervention on Inflammatory Bowel Disease for Nurses in Brazil

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Open Journal of Nursing 2020年第12期10卷 1178-1185页

作者： Jaqueline Ribeiro de Barros Adriana Rivera-Sequeiros Julio pinheiro Baima Fernanda Lofiego Renosto rogerio Saad-Hossne Ligia Yukie Sassaki Department of Internal Medicine Medical School S&#227 o Paulo State University (UNESP) Botucatu Brazil Department of Internal Medicine San Juan de Dios del Aljarafe Hospital Seville Spain Department of Surgery Medical School S&#227 o Paulo State University (UNESP) Botucatu Brazil

Background: The inflammatory bowel disease nurse plays a key role in the multidisciplinary team. The aim of the study was to evaluate the inflammatory bowel disease knowledge before and after the educational intervention with nurses. Methods: A cross-sectional, descriptive and comparative study was performed from June to August 2016. The sample consisted of 26 nurses from the nursing staff of a public university hospital in São Paulo State, Brazil. The study was divided into three phases: pre-educational intervention, educational intervention and post-educational intervention (test application). A p-value Results: The study included 26 general nurses with an average of 9.20 ± 5.78 years of experience. There was an increase in safety in administering biological therapy after the course (from 33.34% to 78.26%), and an increase in knowledge about the main inflammatory bowel disease symptoms (64.29% vs 96.30%, p = 0.0224), and about infliximab infusion (35.71% vs 74.07%, p = 0.0404). Conclusion: The educational intervention effectively contributed to the increase of knowledge of the nursing staff.

关键词： Inflammatory Bowel Diseases Knowledge Nursing Education Nurses Continuing Education

The Impact of a Real-Life Inflammatory Bowel Disease Education Course for Brazilian Physicians from the Perspective of Its Participants

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Open Journal of Gastroenterology 2021年第9期11卷 151-160页

作者： Rodrigo Fedatto Beraldo Julio pinheiro Baima Jaqueline Ribeiro de Barros Fernanda Lofiego Renosto rogerio Saad-Hossne Ligia Yukie Sassaki Department of Internal Medicine Medical School S&#227o Paulo State University (Unesp) Botucatu Brazil Department of Surgery Medical School S&#227o Paulo State University (Unesp) Botucatu Brazil

Background: Physicians must acquire the necessary skills to provide Inflammatory Bowel Disease (IBD) patients with state-of-the-art clinical care, aiming to improve patient’s quality of life and disease outcomes. Purpose: To describe the queries and experiences of doctors enrolled in an IBD education course and to evaluate the impact of the course. Methods: A retrospective study included 100 physicians, of which 78 attended the course. A questionnaire was applied evaluating how the course had an impact on their IBD-knowledge. The 20-hour-course consisted of practical “real-life” activities and theoretical discussions. Results: The majority of doctors’ expertise was in gastroenterology (53%) and coloproctology (44%). A significant portion had no experience with biological therapy for ulcerative colitis (19.4%) or Crohn’s disease (5.05%). The main topics doctors wanted to discuss were biological therapy (93%), new drugs (74%) and differential diagnosis (64%). A considerable number of physicians did not feel confident at prescribing biological therapy before the course (44.4%), a percentage that decreased to 8.5% after the course (p Discussion: The ideal course should have a practical and theoretical component, as well as the support of an experienced multidisciplinary team. A real-life practical-theoretical IBD course proved a success at increasing IBD knowledge.

关键词： Continuing Medical Education Crohn’s Disease Ulcerative Colitis Inflammatory Bowel Disease

A Mathematical Model for the Velocity Profile Internally to a Conical Diffuser

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Journal of Energy and Power Engineering 2013年第8期7卷 1472-1477页

作者： Disterfano Lima Martins Barbosa Jerson rogerio pinheiro Vaz Daborah Aline Tavares Dias do Rio Vaz Sivio Wesley Oliveira Figueiredo Marcelo Oliveira da Silva Andre Luiz Amarante Mesquita Claudio JoseCavalcante Blanco Faculty of Mechanical Engineering Institute of Technology Federal University of Par6 Bel~m 66075-110 Brazil Natural Resources Engineering Post-Graduation Program Institute of Technology Federal University of Par6 Bel~m 66075-110Brazil Faculty of Sanitary and Environmental Engineering Institute of Technology Federal University of Parci BelOm 66075-110 Brazil

The use of diffusers around the horizontal-axis wind turbines has been widely studied since the diffuser improves the power coefficient of the turbine and it is often called DAWTs （diffuser augmented wind turbines）.Turbines using diffuser are called DWATs （Diffuser Augmented Turbines）,and have efficiency bigger than the Betz limit （maximum energy flow extracted = 59.26%）. Thus, this study presents a mathematical model describing the behavior of the velocity profile internally to a diffuser according to the characteristics of flow and geometry of a conical diffuser. The results are compared with experimental data and show good agreement.

关键词： DAWTs diffuser renewable energy.