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Association of Helicobacter pylori infection and giardiasis: Results from a study of surrogate markers for fecal exposure among children

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World Journal of Gastroenterology 2005年第18期11卷 2759-2763页

作者： Edson Duarte Moreira Jr Victor Bastos Nassri Rafaela Sousa Santos Junísia Ferraz Matos Wilson Andrade de Carvalho Célia Stolve Silvani Círia Santana e Sant'Ana Núcleo de Apoio à Pesquisa Fundac■o Irm■ Dulce Salvador Bahia Brazil Centro de Pesquisas Goncalo Moniz Fundac■o Oswaldo Cruz Salvador Bahia Brazil Diretoria Científica e Laboratório do Hospital S■o Rafael Salvador Bahia Brazil Núcleo de Apoio à Pesquisa Fundac■o Irm■Dulce Salvador Bahia Brazil Centro de Pesquisas Goncalo Moniz Fundac■o Oswaldo Cruz Salvador Bahia Brazil Diretoria Científica e Laboratório do Hospital S■o Rafael Salvador Bahia Brazil Diretoria Científica e Laboratório do Hospital S■o Rafael Salvador Bahia Brazil Diretoria Científica e Laboratório do Hospital S(?)o Rafael Salvador Bahia Brazil Núcleo de Apoio à Pesquisa Fundac(?)o Irm(?) Dulce Salvador Bahia Brazil

AIM: To investigate whether Helicobacter pylori (H pylori) infection is associated with hepatitis A virus (HAV) infection, presence of enteroparasites, and other surrogates of fecal exposure. METHODS: We conducted a cross-sectional study in 121 children consecutively admitted at a pediatric hospital in Salvador, Brazil. H pyloriand HAV infection were identified by the presence of serum antibodies. Stool specimens were examined for the presence of ova and parasites. A structured questionnaire inquiring about sanitary conditions and life style was applied to each subject. RESULTS: Fifty-one of the 121 children (42.1%) were found to be seropositive for H pylori, and 45 (37.2%) for HAV. The seroprevalence of Hpyloriand HAV both increased significantly with age. Cross-tabulation of data showed that 26 (21.5%) were seropositive and 51 (42.1%) were negative for both H py/lriand HAV antibodies (x^2=7.18, OR=2.8, CI 1.30-5.97). The age adjusted OR for an HAV-infected child being H pylori positive was 2.3 (CI 1.02-5.03). The agreement between H pylori and HAV seropositivity was fair (k=0.24). After controlling for possible confounding, the variables remaining independently associated with seropositivity to H pylori were age, presence of Giardia lamblia in feces (OR=3.2, 95%CI, 1.1-9.5) and poor garbage disposal quality (OR=2.4, 95%CI, 1.1-5.1). CONCLUSION: Our data suggest that H pylori infection is associated with surrogate markers of fecal exposure. Thus, we conclude that the fecal-oral route is relevant in the transmission of HP among children in an urban setting of a developing country. The association observed between G. lamblia and H pylori infection may have several explanations. Further studies to investigate this relationship are warranted.

关键词： H pylori Hepatitis A virus Epidemiology Transmission Enteroparasites Brazil

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Epidemiology and Clinical Features of Mycobacterium avium Complex Pulmonary Disease in a Brazilian Amazon Cohort

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Advances in Microbiology 2024年第6期14卷 287-302页

作者： Jose Tadeu Colares Monteiro Adriana Rodrigues Barretto Ruan Seguin Azevedo Quaresma Bianca Miranda Gouveia Ismari Perini Furlaneto Victória Menezes da Costa Yan Corrêa Rodrigues Layana Rufino Ribeiro Ricardo J. de Paula Souza e Guimarães Alex Brito Souza Ana Roberta Fusco da Costa Karla Valéria Batista Lima Joao de Barros Barreto University Hospital Federal University of Par Belm Brazil Center for Biological and Health Sciences Ph.D. Program in Parasitic Biology in the Amazon Region (PPGBPA) State University of Par (UEPA) Belm Brazil Department of Medicine Centro Universitrio do Par CESUPA Belm Brazil Bacteriology and Mycology Section Evandro Chagas Institute (SABMI/IEC) Ministry of Health Ananindeua Brazil Geoprocessing Laboratory Evandro Chagas Institute/SVSA/MS Ananineua Brazil

The incidence of Mycobacterium avium complex pulmonary disease (MACPD) has been globally increasing. The present study aims to provide a comprehensive analysis of clinical characteristics and treatment response among patients in the Amazon region of Brazil and conduct a retrospective cohort study at a prominent referral hospital in the State of Par, Brazil, from 2012 to 2020. The M. avium group represented 58.9% of cases, followed by M. intracellulare (35.7%), M. colombiense (3.6%), and M. chimaera (1.8%). The majority of patients (73.2%) were female and with an average age of 63 years. Primary clinical manifestations included persistent cough and sputum production. The Charlson comorbidity index (CCI) averaged 2.47, with 36.3% of patients having a CCI score equal to higher than 3. Notably, over 70% of patients had received treatment for pulmonary tuberculosis before initiating treatment for MAC infection. The fibrocavitary radiologic form was the most prevalent (55.4%), frequently exhibiting a bilateral distribution (53.6%). Antimicrobial susceptibility revealed a significant prevalence of MAC resistance to drugs in the therapeutic regimen. Despite this, most of the patients experienced clinical improvement (50%). In conclusion, this study highlights a higher prevalence of MAC infections among middle-aged women, with a history of pulmonary tuberculosis treatment and presenting the fibrocavitary radiological form was predominant.

关键词： MACDP Nontuberculous Mycobacteria Mycobacterium avium Lung Disease

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Interplay between nitric oxide and VIP in CCK-8-induced phasic contractile activity in the rabbit sphincter of Oddi

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World Journal of Gastroenterology 2005年第21期11卷 3264-3266页

作者： Attila Pálv(o|¨)lgyi Réka Sári József Németh Annamária Szabolcs István Nagy Péter Hegyi János Lonovics Zoltán Szilvássy First Department of Medicine Faculty of Medicine University of SzegedH-6720 SzegedKorányi fasor 8-10 Hungary Department of Pharmacology Medical University of Pécs H-7643 Pécs Szigeti u. 12 Hungary First Department of Medicine Faculty of Medicine University of Szeged H-6720 Szeged Korányi fasor 8-10 Hungary Department of Pharmacology Medical University of Debrecen H-4032 DebrecenNagyerdei krt.98Hungary

AIM: The sphincter of Oddi (SO) plays an important role in delivery of bile into the duodenum. To establish whether vasoactive intestinal polypeptide (VIP) and nitric oxide (NO) were involved in phasic contractile activity of the rabbit SO stimulated by cholecystokinin-octapeptide (CCK-8). METHODS: Isolated SO muscle rings were cleaned of fat and mounted horizontally on two small L-shaped hooks one of which was connected to a force transducer for the measurement of isometric *** experiments were carried out in a thermostatically controlled (37±0.2℃) organ bath (5 mL) containing Krebs *** organ fluid was gassed with 95% O2 and 50 mL/L CO2 to keep the pH at 7.40±0.05. Contractile responses to CCK-8 (1 μmol/L) were evaluated in the presence and absence of NG-nitro-L-arginine (LNNA), an inhibitor of NO synthase (100 μmol/L), and (p-chloro-D-Phe6-Leu17)-VIP (VlPa, 30 μmol/L), a VIP receptor antagonist. RESULTS: CCK-8 stimulated the phasic activity of the SO. NO synthase inhibition increased the frequency and amplitude of contractions with a slight increase in developed tension. Pre-incubation with VlPa also attenuated this CCK-8 effect. The combined application of LNNA and VlPa abolished the phasic activity of the muscle rings with a marked increase in tension in response to CCK-8. CONCLUSION: VIP and NO together contribute to an increase in phasic activity of SO.

关键词： Sphincter of Oddi CCK VIP NO LNNA

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Biliary drainage in inoperable malignant biliary distal obstruction: A systematic review and meta-analysis

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World Journal of Gastrointestinal Surgery 2021年第5期13卷 493-506页

作者： Maria Vitória Cury Vieira Scatimburgo Igor Braga Ribeiro Diogo Turiani Hourneaux de Moura Vitor Massaro Takamatsu Sagae Bruno Salomão Hirsch Mateus Bond Boghossian Thomas R McCarty Marcos EduardoLera dos Santos Tomazo Antonio Prince Franzini Wanderley Marques Bernardo Eduardo GuimarãesHourneaux de Moura Gastrointestinal Endoscopy Unit Hospital das Clínicas da Faculdade de Medicina da Universidade de São PauloSão Paulo 05403-010Brazil Division of Gasteoenterology Hepatology and EndoscopyBrigham and Women's HospitalBostonMA 02115United States

BACKGROUND Endoscopic drainage remains the treatment of choice for unresectable or inoperable malignant distal biliary obstruction(MDBO).AIM To compare the safety and efficacy of plastic stent(PS)vs self-expanding metal stent(SEMS)placement for treatment of *** This meta-analysis was developed according to Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines.A comprehensive search was performed in MEDLINE,Cochrane,Embase,Latin American and Caribbean Health Sciences Literature,and grey literature to identify randomized clinical trials(RCTs)comparing clinical success,adverse events,stent dysfunction rate,reintervention rate,duration of stent patency,and mean *** difference(RD)and mean difference(MD)were calculated and heterogeneity was assessed with I2 *** analyses were performed by SEMS *** Twelve RCTs were included in this study,totaling 1005 *** was no difference in clinical success(RD=-0.03,95%confidence interval[CI]:-0.01,0.07;I 2=0%),rate of adverse events(RD=-0.03,95%CI:-0.10,0.03;I2=57%),and mean patient survival(MD=-0.63,95%CI:-18.07,19.33;I2=54%)between SEMS vs PS ***,SEMS placement was associated with a lower rate of reintervention(RD=-0.34,95%CI:-0.46,-0.22;I2=57%)and longer duration of stent patency(MD=125.77 d,95%CI:77.5,174.01).Subgroup analyses revealed both covered and uncovered SEMS improved stent patency compared to PS(RD=152.25,95%CI:37.42,267.07;I2=98%and RD=101.5,95%CI:38.91,164.09;I2=98%;respectively).Stent dysfunction was higher in the covered SEMS group(RD=-0.21,95%CI:-0.32,-0.1;I²=205%),with no difference in the uncovered SEMS group(RD=-0.08,95%CI:-0.56,0.39;I²=87%).CONCLUSION While both stent types possessed a similar clinical success rate,complication rate,and patient-associated mean survival for treatment of MDBO,SEMS were associated with a longer duration of stent patency compared to PS.

关键词： Biliary tract neoplasms Stents Protheses Malignancy Biliary system Cancer

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Thromboelastographic Profile of Patients with Hyperparathyroidism Secondary to Chronic Kidney Failure Submitted to Total Parathyroidectomy

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Open Journal of Anesthesiology 2013年第8期3卷 363-366页

作者： Walkíria Wingester Vilas Boas Cristiano Barbosa de Oliveira Thadeu Alves Máximo Carlos Alexandre de Freitas Trindade Alexandre de Andrade Sousa Developed in Hospital das Clínicas da Universidade Federal de Minas Gerais HC-UFMG Belo Horizonte Brazil

Coagulopathy in surgical patients can cause perioperative complications, as both bleeding and thromboembolic events increase surgical morbimortality. The recognition of preexisting disorders and the understanding of the dynamic changes in hemostasis during surgery are prerequisites of safe patient management. The perioperative management of patients with chronic kidney failure is a huge challenge due to both the hypercoagulable state and increased risk of bleeding. Classic laboratory exams performed for the evaluation of blood clotting seem insufficient regarding the determination of the risk of bleeding and thrombosis in surgical patients. As patients with chronic kidney failure develop secondary hyperparathyroidism, the aim of the present study was to describe a case series and correlate the perioperative thromboelastographic profile of patients with chronic kidney failure submitted to parathyroidectomy with their secondary hyperparathyroidism.

关键词： Thromboelastography Chronic Renal Failure Hyperparathyroidism Total Thyroidectomy

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In Vitro Propagation and Conservation of Zeyheria montana Mart:An Endangered Medicinal Plant

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American Journal of Plant Sciences 2013年第3期4卷 519-523页

作者： Bianca Waléria Bertoni Rita Maria Moraes Laura Lemo Previdelli Paulo Sérgio Pereira Suzelei de Castro Franca Ana Maria Soares Pereira UNAERP—Unidade de Biotecnologia de Plantas Medicinais Ribeirao PretoBrasil National Center for Natural Products Research The University of MississippiOxfordUSA

Roots of Zeyheriamontana, a species native to the savanna (Cerrado) region of central Brazil, produce lapachol, a naphthoquinone with anticancer activity. Lapachol is also the precursor of β-lapachone, a novel drug candidate for preventive and adjuvant cancer therapies. The leaves of Z. montana are a renewable source of ursolic acid and oleanoic acid, compounds known for their anticancer, antioxidant and antimicrobial properties. The potential prophylactic use of β-lapachone, as well as the medicinal properties of ursolic acid, highlights the importance of this study on ***’s germplasm conservation. Multiple shoots were induced on Woody Plant media with supplemented 0.1 mg·L-1 of thidiazuron (TDZ). Rooting was promoted on half strength WP (Woody Plant media containing 1.0 mg·L-1 of Indolbutiric acid-IBA). Plantlet acclimatization to ex-vitro condition was done at a 70% success rate using different substrates. It was possible to store ***’s elite germplasm using in vitro cultures of media containing 2% sucrose plus 4% sorbitol for six months without subcultures.

关键词： Cerrado Bignoniaceae Micropropagation Germplasm Storage Lapachol and Triterpenes

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Proton nuclear magnetic resonance-based metabonomic models for non-invasive diagnosis of liver fibrosis in chronic hepatitis C:Optimizing the classification of intermediate fibrosis

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World Journal of Hepatology 2018年第1期10卷 105-115页

作者： Andrea Dória Batista Carlos Jonnatan Pimentel Barros Tássia Brena Barroso Carneiro Costa Michele Maria Goncalves de Godoy Ronaldo Dionísio Silva Joelma Carvalho Santos Mariana Montenegro de Melo Lira Norma ThoméJucá Edmundo Pessoa de Almeida Lopes Ricardo Oliveira Silva Postgraduate Program in Tropical Medicine Center for Health SciencesUniversidade Federal de PernambucoRecifePernambuco 50670-901Brazil Department of Gastroenterology and Hepatology Hospital das ClínicasUniversidade Federal de PernambucoRecifePernambuco 50670-901Brazil Department of Fundamental Chemistry Center for Exact and Nature SciencesUniversidade Federal de PernambucoRecifePernambuco 50670-901Brazil Intensive Care Unit Hospital das ClínicasUniversidade Federal de PernambucoRecifePernambuco 50670-901Brazil Department of Pathology Hospital das ClínicasUniversidade Federal de PernambucoRecifePernambuco 50670-901Brazi

AIM To develop metabonomic models(MMs), using 1 H nuclear magnetic resonance(NMR) spectra of serum, to predict significant liver fibrosis(SF: Metavir ≥ F2), advanced liver fibrosis(AF: METAVIR ≥ F3) and cirrhosis(C: METAVIR = F4 or clinical cirrhosis) in chronic hepatitis C(CHC) patients. Additionally, to compare the accuracy of the MMs with the aspartate aminotransferase to platelet ratio index(APRI) and fibrosis index based on four factors(FIB-4). METHODS Sixty-nine patients who had undergone biopsy in the previous 12 mo or had clinical cirrhosis were included. The presence of any other liver disease was a criterion for exclusion. The MMs, constructed using partial least squares discriminant analysis and linear discriminant analysis formalisms, were tested by cross-validation, considering SF, AF and C. RESULTS Results showed that forty-two patients(61%) presented SF, 28(40%) AF and 18(26%) C. The MMs showed sensitivity and specificity of 97.6% and 92.6% to predict SF; 96.4% and 95.1% to predict AF; and 100% and 98.0% to predict C. Besides that, the MMs correctly classified all 27(39.7%) and 25(38.8%) patients with intermediate values of APRI and FIB-4, respectively. CONCLUSION The metabonomic strategy performed excellently in predicting significant and advanced liver fibrosis in CHC patients, including those in the gray zone of APRI and FIB-4, which may contribute to reducing the need for these patients to undergo liver biopsy.

关键词： Metabolomics Nuclear magnetic resonance spectroscopy Chronic hepatitis C Liver fibrosis Surrogate markers

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Illness Experience in a Very Low Income/Poor District of Rio de Janeiro, Brazil: Tuberculosis, Medication Adherence and Common Mental Disorders

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Health 2017年第3期9卷 534-555页

作者： Gisele O’Dwyer Valéria Lino Nádia Rodrigues Monica Kramer Ines Reis Vera Frossard Eliane Vianna Lucília Elias Carlos Eduardo Estellita-Lins National School of Public Health Rio de Janeiro Brazil Institute of Scientific and Technological Communication and Information in Health Rio de Janeiro Brazil

Introduction: Tuberculosis is a global health problem. Improving medication adherence is an important attribute concerning the outcome of tuberculosis treatment. This study investigates illness experience of patients belonging to a low-income district within Manguinhos catchment area. Narrative studies are able to unfold features concerning patient adherence and co-occurrence of depressive symptoms. Methods: Twenty-three patients under treatment were interviewed using McGill Illness Narrative Interview (MINI-McGILL), besides depression screening with “Self-Report Questionnaire-20” (SRQ-20) and “Beck Depression Inventory” (BDI). Results: Explanatory models disregarded airborne microorganism contagion, known but not considered relevant while bohemian or deviant lifestyle was rather perceived as a causal model. Patients mentioned contiguous events suggesting pneumonia or influenza misdiagnosis before final tuberculosis diagnosis (testing or suspicion). Therapeutic pathways were erratic, suggesting low literacy level and postponed or inadequate diagnosis accuracy. Emergency units or private services usually stood for primary care units considered first choice by planners. Expressions such as “dreadful/shameful disease” or “very heavy illness” acknowledged stigma. Research data detected the importance of social network role, highlighting the family through financial and affective support. Hopelessness and depression were closely related to illness suffering and adversities. The percentage of patients for positive common mental disorder and depression approaches 30%. Conclusion: Tuberculosis remains a stigmatizing disease. Building effective health services networks, comprising treatment facilities, community and family resources are very important to improve medication adherence. Effective tuberculosis management through health teams training seems necessary. Incorporating simple screening instruments for depression assessment might promote well-being and patient adheren

关键词： Tuberculosis Patient Adherence Depression Common Mental Disorders Primary Health Care Social Support Health Sevices Accessibility

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Risk Stratification in Obstetrics: An Integrated Approach to Maternal Health

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Open Journal of Obstetrics and Gynecology 2024年第6期14卷 903-910页

作者： Taina Crespo Mendonca Bianca Beatriz Soares dos Reis Júlia Cruz Coelho Antônio de Oliveira Battistini Pestana Vitória Carolina Barreto Negri Alvaro Augusto Trigo Department of Medicine University of Franca Franca Brazil

Introduction: Prenatal care is crucial for maternal and fetal health, highlighting the importance of obstetric risk stratification. This enables personalized care, avoiding unnecessary interventions and reducing costs. Conditions such as first trimester bleeding, spontaneous abortion, gestational trophoblastic disease, and ectopic pregnancy require specific approaches. Early identification of these complications is vital, especially in urgent and emergency obstetric cases, which demand immediate hospital attention. Objective: Comprehensive review of first trimester pathologies and gestational hypertension, focusing on obstetric risks and personalized prenatal management. Methods: Literature review on bleeding and gestational hypertension. Results: The study provides a detailed analysis of pathologies associated with first trimester uterine bleeding and hypertensive disorders, focusing on obstetric risk stratification. The main causes of maternal and fetal mortality are hypertensive disorders, hemorrhages, infections, childbirth complications, and abortion. Spontaneous abortion is common, with different classifications, ranging from threatened to missed abortion. Infected abortion is a severe complication. Brazil has restrictive abortion laws, but many unsafe abortions occur, resulting in high public health costs. Pharmacological treatment with misoprostol is a safe option. Other pathologies include gestational trophoblastic disease, ectopic pregnancy, and placenta previa. Preeclampsia and eclampsia are severe conditions requiring immediate treatment to avoid complications. Conclusion: Early identification and management of obstetric risk factors, such as uterine bleeding, are essential for positive maternal and fetal outcomes. A multidisciplinary approach is fundamental.

关键词： Obstetrics Emergencies Hypertension Pregnancy-Induced Uterine Hemorrhage Pregnancy Trimester First

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Bone disorders in experimentally induced liver disease in growing rats

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World Journal of Gastroenterology 2005年第45期11卷 7169-7173页

作者： Viktória Ferencz Csaba Horváth Béla Kári János Gaál Szilvia Mészáros Zsuzsanna Wolf Dalma Heged(?)s Andrea Horváth Anikó Folhoffer Ferenc Szalay 1st Department of Internal Medicine Department of Diagnostic Radiology and Oncotherapy Department of Polymer Engineering and Textile Technology

AIM： To investigate the change of bone parameters in a new model of experimentally induced liver cirrhosis and hepatocellular carcinoma （HCC） in growing rats. METHODS： Fischer-344 rats （n = 55） were used. Carbon tetrachloride （CCh）, phenobarbital （PB）, and a single diethylnitrosamine （DEN） injection were used. Animals were killed at wk 8 and 16. Bone mineral content, femoral length, cortical index （quotient of cortical thickness and whole diameter） and ultimate bending load （Fmax） of the femora were determined. The results in animals treated with DEN＋PB＋CCh （DPC, n = 21） were com- pared to those in untreated animals （UNT, n = 14） and in control group treated only with DEN＋PB （DP, n = 20）. RESULTS： Fatty liver and cirrhosis developed in each DPC-treated rat at wk 8 and HCC was presented at wk 16. No skeletal changes were found in this group at wk 8, but each parameter was lower （P〈0.05 for each） at wk 16 in comparison to the control group. Neither fatty liver nor cirrhosis was observed in DP-treated animals at any time point. Femoral length and Fmax values were higher （P〈0.05 for both） in DP-treated animals at wk 8 compared to the UNT controls. However, no difference was found at wk 16. CONCLUSION： Experimental liver cirrhosis and HCC are accompanied with inhibited skeletal growth, reduced bone mass, and decreased mechanical resistance in growing rats. Our results are in concordance withthe data of other studies using different animal models. A novel finding is the transiently accelerated skeletal growth and bone strength after a 8-wk long phenobarbital treatment following diethylnitrosamine injection.

关键词： Bone disorder Bone mineral content Mechanical resistance Experimental liver cirrhosis Growingrat

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