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Appropriateness of the study of iron deficiency anemia prior to referral for small bowel evaluation at a tertiary center

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World Journal of Gastroenterology 2017年第24期23卷 4444-4453页

作者： Jaime Pereira Rodrigues rolando pinho Joana Silva Ana Ponte Mafalda Sousa Joao Carlos Silva Joao Carvalho Department of Gastroenterology Centro Hospitalar Vila Nova de Gaia/EspinhoRua Conceicao FernandesVila Nova de Gaia

To evaluate the adequacy of the study of iron deficiency anemia (IDA) in real life practice prior to referral to a gastroenterology department for small bowel evaluation. METHODSAll consecutive patients referred to a gastroenterology department for small bowel investigation due to iron deficiency anemia, between January 2013 and December 2015 were included. Both patients referred from general practitioners or directly from different hospital departments were selected. Relevant clinical information regarding prior anemia workup was retrospectively collected from medical records. An appropriate pre-referral study was considered the execution of esophagogastroduodenoscopy (EGD) with Helicobacter pylori (H. pylori) investigation, colonoscopy with quality standards (recent, total and with adequate preparation) and celiac disease (CD) screening (through serologic testing and/or histopathological investigation). RESULTSA total of 77 patients (58.4% female, mean age 67.1 ± 16.7 years) were included. Most (53.2%) patients were referred from general practitioners, 41.6% from other hospital specialties and 5.2% directly from the emergency department. The mean pre-referral hemoglobin concentration was 8.8 ± 2.0 g/dL and the majority of anemias had microcytic (71.4%) and hypochromic (72.7%) characteristics. 77.9% of patients presented with an incomplete pre-referral study: EGD in 97.4%, with H. pylori investigation in 58.3%, colonoscopy with quality criteria in 63.6%, and CD screening in 24.7%. Patients with an appropriate study at the time of referral were younger (48.7 ± 17.7 vs 72.3 ± 12.3 years, P < 0.001). Small bowel evaluation was ultimately undertaken in 72.7% of patients, with a more frequent evaluation in patients with a quality colonoscopy at referral (78.6% vs 23.8%); P < 0.001 (OR = 11.7, 95%CI: 3.6-38.6). The most common diagnosis regarded as the likely cause of IDA was small bowel angioectasia (18.2%) but additional causes were also found in the upper and lower ga

关键词： Iron deficiency anemia Colonoscopy Celiac disease Esophagogastroduodenoscopy Helicobacter pylori Small bowel

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Utility of the balloon-overtube-assisted modified over-thewire stenting technique to treat post-sleeve gastrectomy complications

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World Journal of Gastrointestinal Endoscopy 2017年第6期9卷 267-272页

作者： Ana Ponte rolando pinho Luísa Proenca Joana Silva Jaime Rodrigues Mafalda Sousa Joao Carlos Silva Joao Carvalho Department of Gastroenterology Centro Hospitalar Vila Nova de Gaia/EspinhoVila Nova de Gaia4434-502 PortoPortugal

AIM To describe a modified technique of deployment of stents using the overtube developed for balloonassisted enteroscopy in post-sleeve gastrectomy(SG) complications. METHODS Between January 2010 and December 2015, all patients submitted to an endoscopic stenting procedure to treat a post-SG stenosis or leakage were retrospectively collected. Procedures from patients in which the stent was deployed using the balloon-overtube-assisted modified over-the-wire(OTW) stenting technique were described. The technical success, corresponding to proper placement of the stent in the stomach resulting in exclusion of the SG leak or the stenosis, was evaluated. Complications related to stenting were also *** Five procedures were included to treat 2 staple line leaks and 3 stenoses. Two types of stents were used, including a fully covered self-expandable metal stent designed for the SG anatomy(Hanarostent, ECBB-30-240-090; M.I. Tech, Co., Ltd, Seoul, SouthKorea) in 4 procedures and a biodegradable stent(BD stent 019-10A-25/20/25-080, SX-ELLA, Hradec Kralove, Czech Republic) in the remaining procedure. In all cases, an overtube was advanced with the endoscope through the SG to the duodenum. After placement of the guidewire and removal of the endoscope, the stent was easily advanced through the overtube. The overtube was pulled back and the stent was successfully deployed under fluoroscopic guidance. Technical success was achieved in all *** The adoption of a modified technique of deployment of OTW stents using an overtube may represent an effective option in the approach of SG complications.

关键词： Bariatric surgery Sleeve gastrectomy Stenosis Anastomotic leaks Balloon-overtube Stent

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Yield of capsule endoscopy in obscure gastrointestinal bleeding:A comparative study between premenopausal and menopausal women

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World Journal of Gastrointestinal Endoscopy 2018年第10期10卷 301-307页

作者： Joao Carlos Silva rolando pinho Adélia Rodrigues Ana Ponte Jaime Pereira Rodrigues Mafalda Sousa Catarina Gomes Joao Carvalho Department of Gastroenterology Centro Hospitalar Vila Nova de Gaia/EspinhoPorto 4434-502Portugal

AIM To evaluate differences in capsule endoscopy(CE) performed in the setting of obscure gastrointestinal bleeding(OGIB) among premenopausal women(PMW) and menopausal women(MW).METHODS Retrospective, single-center study, including female patients submitted to CE in the setting of OGIB between May 2011 and December 2016. Patients were divided into 2 groups according to age, considering fertile age as ≤ 55 years and postmenopausal age as > 55 years. The diagnostic yield(DY), the rebleeding rate and the time to rebleed were evaluated and compared between groups. Rebleeding was defined as a drop of Hb > 2 g/dL or need for transfusional support or presence of melena/*** A hundred and eighty three female patients underwent CE for OGIB, of whom 30.6%(n = 56) were PMW and 69.4%(n = 127) were MW. The DY was 30.4% in PMW and 63.8% in MW. The most common findings were angiodysplasias in both groups(PMW: 21.4%, MW: 44.9%)(P = 0.003). In PMW, only 1.8% required therapeutic endoscopy. In 17.3% of MW, CE findingsled to additional endoscopic treatment. Rebleeding at 1, 3 and 5 years in PMW was 3.6%, 10.2%, 10.2% and 22.0%, 32.3% and 34.2% in MW. Postmenopausal status was significantly associated with higher DY(P < 0.001), TY(P = 0.003), rebleeding(P = 0.031) and lower time to rebleed(P = 0.001).CONCLUSION PMW with suspected OGIB are less likely to have significant findings in CE. In MW DY, need for endoscopic treatment and rebleeding were significantly higher while time to rebleed was lower.

关键词： Diagnostic yield Obscure gastrointestinal bleeding Premenopausal women Menopausal women Capsule endoscopy

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Essential role of small bowel capsule endoscopy in reclassification of colonic inflammatory bowel disease type unclassified

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World Journal of Gastrointestinal Endoscopy 2017年第1期9卷 34-40页

作者： Sara Monteiro Francisca Dias de Castro Pedro Boal Carvalho Bruno Rosa Maria Joao Moreira rolando pinho Miguel Mascarenhas Saraiva José Cotter Department of Gastroenterology Hospital da Senhora da Oliveira-Guimaraes ManopH-Endo-scopy and Digestive Motility Laboratory Portugal and CUF Institute School of Medicine University of Minho ICVS/3B’s PT Government Associate Laboratory

AIM To evaluate the role of small bowel capsule endoscopy(SBCE) on the reclassification of colonic inflammatory bowel disease type unclassified(IBDU).METHODS We performed a multicenter, retrospective study including patients with IBDU undergoing SBCE, between 2002 and 2014. SBCE studies were reviewed and the inflammatory activity was evaluated by determining the Lewis score(LS). Inflammatory activity was considered significant and consistent with Crohn's disease(CD) when the LS ≥ 135. The definitive diagnosis during follow-up(minimum 12 mo following SBCE) was based on the combination of clinical, analytical, imaging, endoscopic and histological *** Thirty-six patients were included, 21 females(58%) with mean age at diagnosis of 33 ± 13(15-64) years. The mean follow-up time after the SBCE was 52 ± 41(12-156) mo. The SBCE revealed findings consistent with significant inflammatory activity in the small bowel(LS ≥ 135) in 9 patients(25%); in all of them the diagnosis of CD was confirmed during follow-up. In 27 patients(75%), the SBCE revealed no significant inflammatory activity(LS < 135); among these patients, the diagnosis of Ulcerative Colitis(UC) was established in 16 cases(59.3%), CD in 1 case(3.7%) and 10 patients(37%) maintained a diagnosis of IBDU during follow-up. A LS ≥ 135 at SBCE had a sensitivity = 90%, specificity = 100%, positive predictive value = 100% and negative predictive value = 94% for the diagnosis of *** SBCE proved to be fundamental in the reclassification of patients with IBDU. Absence of significant inflammatory activity in the small intestine allowed exclusion of CD in 94% of cases.

关键词： Inflammatory bowel disease Inflammatory bowel disease type unclassified Capsule endoscopy Crohn’s disease Lewis score Reclassification

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Impact of the timing of capsule endoscopy in overt obscure gastrointestinal bleeding on yield and rebleeding rate-is sooner than 14 d advisable?

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World Journal of Gastrointestinal Endoscopy 2018年第4期10卷 74-82页

作者： Catarina Gomes rolando pinho Adélia Rodrigues Ana Ponte Joana Silva Jaime Pereira Rodrigues Mafalda Sousa Joao Carlos Silva Joao Carvalho Department of Gastroenterology Centro Hospitalar Vila Nova de Gaia/EspinhoPorto 4434502Portugal

AIM To evaluate the impact of the timing of capsule endoscopy(CE) in overt-obscure gastrointestinal bleeding(OGIB). METHODS Retrospective, single-center study, including patients submitted to CE in the setting of overt-OGIB between January 2005 and August 2017. Patients were divided into 3 groups according to the timing of CE(≤ 48 h; 48 h-14 d; ≥ 14 d). The diagnostic and therapeutic yield(DY and TY), the rebleeding rate and the time to rebleed were calculated and compared between groups. The outcomes of patients in whom CE was performed before(≤ 48 h) and after 48 h(> 48 h), and before( 48 h groups(P = 0.03).CONCLUSION Performing CE within 48 h from overt-OGIB is associated to a higher TY and a lower rebleeding rate and longer time to rebleed.

关键词： Overt-obscure gastrointestinal bleeding Capsule endoscopy Timing Diagnosis Therapeutic Rebleeding

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Dietary eubiotics of microbial muramidase and glycan improve intestinal villi,ileum microbiota composition and production trait of broiler

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Journal of Animal Science and Biotechnology 2024年第4期15卷 1723-1736页

作者： Sungbo Cho Shanmugam Suresh Kumar Santiago Ramirez rolando Valientes In Ho Kim Department of Animal Resource and Science Dankook UniversityCheonanChungnam 31116Korea Smart Animal Bio Institute Dankook University CheonanKorea DSM Nutritional Products Asia Pacific Mapletree Business CitySingapore 117440Singapore

Background Optimal gut health is important to maximize growth performance and feed efficiency in broiler chickens.A total of 1,365 one-day-old male Ross 308 broiler chickens were randomly divided into 5 treatments groups with 21 replicates,13 birds per *** present research investigated effects of microbial muramidase or a precision glycan alone or in combination on growth performance,apparent total tract digestibility,total blood carotenoid content,intestinal villus length,meat quality and gut microbiota in broiler *** included:NC:negative control(basal diet group);PC:positive control(basal diet+0.02%probiotics);MR:basal diet+0.035%microbial muramidase;PG:basal diet+0.1%precision glycan;and MRPG:basal diet+0.025%MR+0.1%PG,*** MRPG group increased the body weight gain and feed intake(P<0.05)compared with NC ***,it significantly increased total serum carotenoid(P<0.05)and MRPG altered the microbial diversity in ileum *** MRPG treatment group increased the abundance of the phylum Firmicutes,and family Lachnospiraceae,Ruminococcaceae,Oscillospiraceae,Lactobacillaceae,Peptostreptococcaceae and decreased the abundance of the phylum Campilobacterota,Bacteroidota and family *** with the NC group,the chickens fed MRPG showed significantly increased in duodenum villus length at end the *** In this study,overall results showed that the synergetic effects of MR and PG showed enhancing growth performance,total serum carotenoid level and altering gut microbiota composition of *** current research indicates that co-supplementation of MR and PG in broiler diets enhances intestinal health,consequently leading to an increased broiler production.

关键词： Broiler Intestinal morphology Microbial muramidase Precision glycan Probiotics

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Introduction to the Special Issue on Computer-Aided Uncertainty Modeling and Reliability Evaluation for Complex Engineering Structures

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Computer Modeling in Engineering & Sciences 2024年第10期141卷 1-5页

作者： Debiao Meng Abílio Manuel pinho de Jesus Zeng Meng School of Mechanical and Electrical Engineering University of Electronic Science and Technology of ChinaChengdu611731China INEGI Faculty of EngineeringUniversity of PortoPorto4200-465Portugal School of Civil Engineering Hefei University of TechnologyHefei230009China

1 Summary With the advancement of science and technology,complex engineering structures are widely used in extreme environments[1].In equipment service,many uncertainty factors significantly affect safety and reliability[2–5].Therefore,ensuring high reliability of structures has become an important research direction in engineering *** the same time,the importance of equipment health management of complex engineering structures is becoming increasingly prominent[6–8].Computer-aided uncertainty modeling and reliability assessment have become key tools,and finite element simulation and algorithmic innovation play a key role in the reliability analysis of complex equipment[9,10].These techniques can accurately simulate stress and damage accumulation under various operating environments,providing engineers with important decision support and optimization solutions.

关键词： extreme Reliability environments

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Review of small-bowel cleansing scales in capsule endoscopy: A panoply of choices

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World Journal of Gastrointestinal Endoscopy 2016年第17期8卷 600-609页

作者： Ana Ponte rolando pinho Adélia Rodrigues Joao Carvalho Department of Gastroenterology Centro Hospitalar Vila Nova de Gaia/Espinho Vila Nova de Gaia 4434-502 Porto Portugal

Evaluation of the quality of small-bowel cleansing is required to assess the reliability of findings in capsule endoscopy(CE). Moreover, consensus regarding the need of intestinal preparation for CE remains to be achieved. The presence of multiple grading scales for smallbowel preparation in CE, which are time-consuming and complicated, adds difficulty to the comparison of different small-bowel cleansing regimens and their application in clinical practice. Nowadays, a validated scale universally accepted for grading small-bowel cleansing is lacking. In fact, there are numerous grading systems with very different technical characteristics, namely, the parameters and the portion of the CE video that are analyzed, the objectivity of the analysis, the lesser or greater dependency on the operator, and the validation of the score. The authors performed a review which aims to systematize and summarize currently available smallbowel grading scales in CE.

关键词： Capsule endoscopy Small-bowel Smallbowel Cleansing Scales Enteroscopy Grading

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Peritoneal interposition flap reduces symptomatic lymphocele following transperitoneal robot-assisted radical prostatectomy and pelvic lymph node dissection:An updated meta-analysis

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Current Urology 2024年第3期18卷 167-176页

作者： João Henrique Sendrete de pinho Lorrane Vieira Siqueira Riscado João Padua Manzano Faculty of Medicine of the Federal University of Juiz de Fora Minas GeraisBrazil Faculty of Medicine of the Federal University of São Paulo São PauloBrazil

Background Robot-assisted radical prostatectomy with intraoperative pelvic lymph node dissection is the criterion standard for surgical treatment of nonmetastatic intermediate-and high-risk prostate ***,this method is associated with symptomatic lymphocele(SLC),which is an important morbidity *** overcome this complication,several modifications of the technique have been developed,including the peritoneal interposition flap(PIF).We performed an updated systematic review and meta-analysis to investigate the efficacy and safety of this technique for preventing SLC and lymphocele(LC)*** and methods Searches were performed using databases and references from included studies and previous systematic *** randomized controlled trials and nonrandomized cohorts were *** outcomes were the incidence of SLC and LC formation,and safety outcomes were defined as operation time,estimated blood loss,length of hospital stay,and urinary *** assessment was performed using the Newcastle-Ottawa Scale and Cochrane Collaboration's *** treatment effects were estimated using odds ratios with 95%confidence intervals(CIs)for binary *** was examined using Cochran's Q test and I2 statistics;p values25%were considered significant for *** used Mantel-Haenszel fixed-effect models in the analyses with low ***,the DerSimonian and Laird random-effects model was *** The initial search yielded 510 *** the removal of duplicate records and application of the exclusion criterion,9 studies were fully reviewed for *** randomized controlled trials and 5 retrospective cohorts met all the inclusion criteria,comprising 2261 patients,of whom 1073(47.4%)underwent *** studies reported a significant reduction in SLC in the PIF group,and 3 of the 4 studies reported LC formation yielded significant results in preventing this complication.

关键词： Robot-assisted radical prostatectomy Lymphocele Peritoneal reapproximation Peritoneal interpolated flap Meta-analysis

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A multi-platform analysis of human gingival crevicular fluid reveals ferroptosis as a relevant regulated cell death mechanism during the clinical progression of periodontitis

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International Journal of Oral Science 2024年第2期16卷 265-279页

作者： Alfredo Torres M.Angélica Michea Ákos Végvári Marion Arce Valentina Pérez Marcela Alcota Alicia Morales rolando Vernal Mauricio Budini Roman A.Zubarev Fermín E.González Laboratory of Experimental Immunology&Cancer Faculty of DentistryUniversity of ChileSantiagoChile Department of Conservative Dentistry Faculty of DentistryUniversity of ChileSantiagoChile Division of Chemistry I Department of Medical Biochemistry and BiophysicsKarolinska InstitutetStockholmSweden Periodontal Biology Laboratory Faculty of DentistryUniversidad de ChileSantiagoChile Laboratory of Cellular and Molecular Pathology Institute for Research in Dental SciencesFaculty of DentistryUniversity of ChileSantiagoChile

Ferroptosis is implicated in the pathogenesis of numerous chronic-inflammatory diseases,yet its association with progressive periodontitis remains *** investigate the involvement and significance of ferroptosis in periodontitis progression,we assessed sixteen periodontitis-diagnosed *** progression was clinically monitored over twelve weeks via weekly clinical evaluations and gingival crevicular fluid(GCF)collection was performed for further *** metrics,proteomic data,in silico methods,and bioinformatics tools were combined to identify protein profiles linked to periodontitis progression and to explore their potential connection with *** western blot analyses validated key ***,a single-cell RNA sequencing(scRNA-seq)dataset(GSE164241)for gingival tissues was analyzed to elucidate cellular dynamics during periodontitis *** progression was identified as occurring at a faster rate than traditionally *** samples from progressing and non-progressing periodontal sites showed quantitative and qualitatively distinct proteomic *** addition,specific biological processes and molecular functions during progressive periodontitis were revealed and a set of hub proteins,including SNCA,CA1,HBB,SLC4A1,and ANK1 was strongly associated with the clinical progression status of ***,we found specific proteins-drivers or suppressors-associated with ferroptosis(SNCA,FTH1,HSPB1,CD44,and GCLC),revealing the co-occurrence of this specific type of regulated cell death during the clinical progression of ***,the integration of quantitative proteomic data with scRNA-seq analysis suggested the susceptibility of fibroblasts to *** analyses reveal proteins and processes linked to ferroptosis for the first time in periodontal patients,which offer new insights into the molecular mechanisms of progressive periodontal *** findings may le

关键词： finding progression faster

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