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Acute bleeding after argon plasma coagulation for weight regain after gastric bypass: A case report

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World Journal of Clinical Cases 2019年第15期7卷 2038-2043页

作者： diogo Turiani Hourneaux de moura Amit H Sachdev Po-Wen Lu Igor Braga Ribeiro Christopher C Thompson Division of Gastroenterology Hepatology and EndoscopyBrigham and Women’s HospitalHarvard Medical SchoolBostonMA 02115United States Department of Gastroenterology Clinics Hospital of Sao Paulo UniversitySao Paulo 05403-00Brazil Department of Gastroenterology and Hepatology Linkou Chang Gung Memorial HospitalTaoyuan City33305Taiwan

BACKGROUND Roux-en-Y gastric bypass(RYGB) is the most commonly performed surgical procedure used to treat obesity worldwide. Despite satisfactory results in terms of weight loss, over time many patients experience weight regain. There are many factors that contribute to weight regain after RYGB, including the diameter of the gastric-jejunal anastomosis(GJA). One of the most commonly performed endoscopic procedures for weight regain after RYGB is argon plasma coagulation(APC). We report a case of hematemesis after outlet revision with APC. We highlight several treatment modalities that can be used to treat this *** SUmmARY A 45-year-old female with a history of weight regain after RYGB was referred for possible endoscopic treatment for weight regain. On endoscopic evaluation, the diameter of the GJA was 22 mm. Due to the dilated GJA, treatment with APC was performed. Several months later she reported a return of poor satiety and an increased appetite. A repeat endoscopy was then performed. The GJA was approximately 15 mm and was incompetent. APC was performed. One day post procedure she had four episodes of hematemesis. An endoscopy was performed and a large ulcer with a visible arterial vessel was visualized at the *** was attempted using a Coagrasper and after initial contact with the vessel, the vessel started oozing. Due to fibrosis and the depth of ulceration in the area, clips and repeat APC could not be used. Therefore, an attempt to inject epinephrine injection was made. However, persistent oozing was noted. As a result, hemostatic powder was applied to the region of the bleeding ***, no more bleeding was observed. On follow-up, the patient remained hemodynamically stable and a second look endoscopy was not performed. The patient was discharged three days *** APC revision of the GJA is known to be a relatively safe and effective strategy to manage weight regain post RYGB. Anastomotic site bleeding is an i

关键词： Anastomosis Roux-en-Y Argon plasma coagulation Bariatric Gastric bypass Gastrointestinal hemorrhage Case report

A Pt/mnV_(2)O_(6) nanocomposite for the borohydride oxidation reaction

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Journal of Energy Chemistry 2021年第4期30卷 428-436页

作者： Jadranka milikic marta martins Ana S.Dobrota Gamze Bozkurt Gulin S.P.Soylu Ayse B.Yurtcan Natalia V.Skorodumova Igor A.Pasti Biljana Sljukic diogo m.F.Santos Faculty of Physical Chemistry University of BelgradeStudentski trg 12-1611158 BelgradeSerbia CeFEmA Instituto Superior TécnicoUniversidade de LisboaLisbonPortugal Project Coordination Implementation and Research Center Erzurum Technical UniversityErzurumTurkey Faculty of Engineering Chemical Engineering DepartmentIstanbul University-Cerrahpasa34320 AvcilarIstanbulTurkey Department of Chemical Engineering Atatürk UniversityErzurumTurkey Department of materials Science and Engineering School of Industrial Engineering and ManagementKTH-Royal Institute of TechnologyBrinellvägen 2310044 StockholmSweden Department of Physics and Astronomy Uppsala UniversityBox 51675120 UppsalaSweden

Problems associated with carbon support corrosion under operating fuel cell conditions require the identification of alternative supports for platinum-based nanosized *** supported on manganese vanadate(Pt/mnV_(2)O_(6))was prepared by microwave irradiation method and characterized using X-ray diffraction,Fourier-transform infrared spectroscopy,X-ray photoelectron spectroscopy,scanning electron microscopy with energy dispersive spectroscopy,and transmission electron *** borohydride oxidation reaction(BOR)on Pt/mnV_(2)O_(6) was studied in highly alkaline media using voltammetry,chronoamperometry,and electrochemical impedance *** electrocatalytic activity of Pt/mnV_(2)O_(6) was also compared with that of commercial Pt/C(46 wt%Pt)*** apparent activation energy of BOR at Pt/mnV_(2)O_(6) was estimated to be 32 k J mol^(-1) and the order of reaction to be 0.51,indicating that borohydride hydrolysis proceeds in parallel with its ***-term stability of Pt/mnV_(2)O_(6) under BOR typical conditions was observed.A laboratory-scale direct borohydride fuel cell assembled with a Pt/mnV_(2)O_(6) anode reached a specific power of 274 W g^(-1).Experimental results on Pt/mnV_(2)O_(6) were complemented by DFT calculations,which indicated good adherence of Pt to mnV_(2)O_(6),beneficial for electrocatalyst stability.

关键词： Borohydride oxidation reaction Platinum-based electrocatalyst manganese vanadate Density functional theory

Anal canal gastrointestinal stromal tumors:Case report and literature review

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World Journal of Gastroenterology 2014年第1期20卷 319-322页

作者： Nuno Carvalho diogo Albergaria Rui Lebre Joo Giria Vitor Fernandes Helena Vidal maria José Brito Department of General Surgery Garcia de Orta Hospital2801-951 AlmadaPortugal Department of Gastroenterology Garcia de Orta Hospital2801-951 AlmadaPortugal Department of Radiology Garcia de Orta Hospital2801-951 AlmadaPortugal Department of Pathology Garcia de Orta Hospital2801-951 AlmadaPortugal

Gastrointestinal stromal tumors (GIST) are an uncommon group of tumors of mesenchymal origin. GIST of the anal canal is extremely rare. At present, only 10 cases of c-kit positive anal GIST have been reported in the literature. There is no widely accepted treatment approach for this neoplasia. Literature is sparse on imaging evaluation of anal canal GIST, usually described as a lesion in the intersphincteric space. We describe the case of a 73-year-old man with a mass in the anal canal, and no other symptoms. Endoanal ultrasound and magnetic resonance imaging showed a well circumscribed solid nodule in the intersphincteric space. The patient was treated by local excision. Gross pathological examination showed a 7 cm × 3.5 cm × 3 cm mass, and histological examination showed a proliferation of spindle cells, with prominent nuclear palisading. The mitotic count was of 12 mitoses/50 HPF. The tumor was positive for KIT protein, CD34 and vimentin in the majority of cells, and negative for desmin and S100. A diagnosis of GIST, with high risk aggressive behavior was made. An abdomino-perineal resection was discussed, but refused. The follow-up included clinical evaluation and anal ultrasound. After 5 years the patient is well, with maintained continence and no evidence of local recurrence.

关键词： Gastrointestinal stromal tumors Anal canal Endoanal ultrasound magnetic resonance imaging C-Kit receptor Local excision

Prevalence and risk factors for acquired long QT syndrome in the emergency department:a retrospective observational study

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World Journal of Emergency medicine 2023年第6期14卷 454-461页

作者： diogo de Almeida Fernandes Guilherme de Freitas Camoes Diana Ferreira Carolina Queijo Carlos Fontes-Ribeiro Lino Gongalves Rui Pina Natalia Antonio Department of Cardiology Coimbra Hospital and University Centre(CHUC)Coimbra 3000-075Portugal Department of Internal medicine Coimbra Hospital and University Centre(CHUC)Coimbra 3000-075Portugal Faculty of medicine University of CoimbraCoimbra 3000-370Portugal Institute for Clinical and Biomedical Research Faculty of MedicineUniversity of CoimbraCoimbra 3000-548Portugal

BACKGROUND: Long QT syndrome(LQTS) is a heterogeneous syndrome that may be congenital or, more frequently, acquired. The real-world prevalence of acquired LQTS(aLQTS) in the emergency department(ED) remains to be determined. The aim of this study was to determine prevalence of aLQTS and its impact on symptoms on ED ***: Electrocardiograms(ECG) of 5,056 consecutively patients admitted in the ED of a tertiary hospital between January 28th and march 17th of 2020 were reviewed. All patients with aLQTS were included. Clinical data with a focus on QT prolonging drugs and clinical factors were recorded. Statistical comparison was made between the groups with and without corrected QT(QTc) interval greater than 500 ms(value that is considered severely increased).RESULTS: A total of 383 ECGs with prolonged QTc were recognized, corresponding to a prevalence of aLQTS at admission of 7.82%. Patients with aLQTS were more commonly men(53.3%) with an age of(73.49±14.79) years old and QTc interval of(505.3±32.4) ms. Only 20.4% of these patients with aLQTS were symptomatic. No ventricular arrhythmias were recorded. Patients with QT interval greater than 500 ms were more frequently female(59.5%;Pmore frequently on QT prolonging drugs(77.3%;P=0.025). main contributing factor was intake of antibiotics(odds ratio [OR] 4.680) followed by female gender(OR 2.473) and intake of antipsychotics(OR 1.925).CONCLUSION: aLQTS is particularly prevalent in the ED. Female patients on antibiotics and antipsychotics are at particularly high risk. Efforts must be made to avoid, detect and treat aLQTS as early as possible.

关键词： Long QT syndrome Epidemiology Drug interactions Emergency department

Oncologic aspects of the decision-making process for surgical approach for colorectal liver metastases progressing during chemotherapy

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World Journal of Gastrointestinal Surgery 2022年第9期14卷 877-886页

作者： Raphael L C Araujo Camila G C Y Carvalho Carlos T maeda Jean michel milani diogo G Bugano Pedro Henrique Z de moraes marcelo m Linhares Department of Surgery Universidade Federal de São PauloSão Paulo 04024-002Brazil Department of Oncology Hospital Israelita Albert EinsteinSão Paulo 05652-900Brazil Department of Surgical Oncology Hospital e Maternidade Brasil Rede D'Or São LuizSanto André09030-590São PauloBrazil

Colorectal cancer represents the third most diagnosed malignancy in the *** liver is the main site of metastatic disease,affected in 30%of patients with newly diagnosed *** resection is considered the only potentially curative treatment for colorectal liver metastasis(CRLm),with a 5-year survival rate ranging from 35%to 58%.However,up to 80%of patients have initially unresectable disease,due to extrahepatic disease or bilobar multiple liver *** availability of increasingly effective systemic chemotherapy has contributed to converting patients with initially unresectable liver metastases to resectable disease,improving long-term outcomes,and accessing tumor *** recent years,response to preoperative systemic chemotherapy before liver resection has been established as a major prognostic *** studies have demonstrated that patients with regression of hepatic metastases while on chemotherapy have improved outcomes when compared to patients with stabilization or progression of the *** if disease progression during chemotherapy represents an independent negative prognostic factor,some patients may still benefit from surgery,given the role of this modality as the main treatment with curative intent for patients with *** selected cases,based on size,the number of lesions,and tumor markers,surgery may be offered despite the less favorable prognosis and as an option for non-chemo responders.

关键词： Colorectal liver metastases Oncology Disease progression Surgery Liver resection Hepatectomy

Choosing the best endoscopic approach for post-bariatric surgical leaks and fistulas:Basic principles and recommendations

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World Journal of Gastroenterology 2023年第7期29卷 1173-1193页

作者： Victor Lira de Oliveira Alexandre moraes Bestetti Roberto Paolo Trasolini Eduardo Guimaraes Hourneaux de moura diogo Turiani Hourneaux de moura Serviço de Endoscopia Gastrointestinal Departamento de GastroenterologiaHospital das Clínicas da Faculdade de Medicina da Universidade de São PauloSão Paulo 05403010Brazil Division of Gastroenterology Hepatology and EndoscopyHarvard Medical SchoolBrigham and Women's HospitalBostonMA 021115United States

Post-surgical leaks and fistulas are the most feared complication of bariatric *** have become more common in clinical practice given the increasing number of these procedures and can be very difficult to *** two related conditions must be distinguished and characterized to guide the appropriate *** is defined as a transmural defect with communication between the intra and extraluminal compartments,while fistula is defined as an abnormal communication between two epithelialized ***,surgical treatment was the preferred approach for leaks and fistulas and was associated with high morbidity with significant mortality ***,with the development of novel devices and techniques,endoscopic therapy plays an increasingly essential role in managing these *** diagnosis and endoscopic therapy initiation after clinical stabilization are crucial to success since clinical success rates are higher for acute leaks and fistulas when compared to late and chronic leaks and *** endoscopic techniques are available with different mechanisms of action,including direct closure,covering/diverting or *** treatment should be individualized by considering the characteristics of both the patient and the *** there is a lack of high-quality studies to provide standardized treatment algorithms,this narrative review aims to provide a summary of the current scientific evidence and,based on this data and our extensive experience,make recommendations to help choose the best endoscopic approach for the management of post-bariatric surgical leaks and fistulas.

关键词： Endoscopy Surgery Bariatric Gastrointestinal Fistulas Leaks

Hyperbaric oxygen therapy as a complementary treatment for radiation proctitis:Useless or useful?-A literature review

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World Journal of Gastroenterology 2021年第27期27卷 4413-4428页

作者： diogo Alpuim Costa Carla Espiney Amaro Ana Nunes Joana Santos Cardoso Pedro modas Daniel Isabel Rosa João Vieira Branco Department of Haematology and Oncology CUF OncologiaLisboa 1998-018Portugal Centro de medicina Subaquática e Hiperbárica(CmSH) Portuguese NavyLisboa 1649-020Portugal Centro de Investigação Naval(CINAV) Portuguese NavyBase Naval do AlfeiteAlmada 2810-001Portugal OVA medical School Faculdade de Ciências MédicasLisboa 1169-056Portugal Department of Otorhinolaryngology Hospital das Forças Armadas(HFAR)Lisboa 1649-020Portugal Department of Gastroenterology Hospital das Forças Armadas(HFAR)Lisboa 1649-020Portugal Department of Vascular Surgery Centro Hospitalar Universitário de Lisboa CentralHospital de Santa MartaLisboa 1169-024Portugal Department of Intensive Care Unit Hospital das Forças Armadas(HFAR)Lisboa 1649-020Portugal Department of General Surgery Hospital das Forças Armadas(HFAR)Lisboa 1649-020Portugal

Radiotherapy(RT)is the backbone of multimodality treatment of more than half of cancer *** new modern RT techniques,late complications may occur such as radiation proctitis(RP).The natural history of RP is *** symptoms may resolve spontaneously or require conservative *** the other hand,for similar and uncomplicated clinical contexts,symptoms may persist and can even be refractory to the progressive increase in treatment *** the last decades,an enormous therapeutic armamentarium has been considered in RP,including hyperbaric oxygen therapy(HBOT).Currently,the evidence regarding the impact of HBOT on RP and its benefits is *** prospective and randomised studies are necessary to validate HBOT’s effectiveness in the‘real world’clinical *** article reviewed the relevant literature on pathophysiology,clinical presentation,different classifications and discuss RP management including a proposal for a therapeutic algorithm with a focus on HBOT.

关键词： Radiation proctitis Radiation proctopathy Radiotherapy Radio-induced lesion Late radiation tissue injury Delayed radiation injury Late sequelae Hyperbaric oxygen therapy Hyperbaric oxygen Review

Development of a Time-Efficient Approach to measure the Acoustic Impedance of Industrial Insulating materials

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Open Journal of Applied Sciences 2019年第2期9卷 55-67页

作者： Etaribo Binaebi-Soroh diogo montalvao University of Hertfordshire Hatfield UK Department of Design and Engineering Bournemouth University Bournemouth UK

This study presents a development on a time efficient approach to measure the Acoustic Impedance of Industrial Insulating materials using an impedance tube with single moveable microphone and a white noise generator. The standing wave method is used to measure the acoustic properties (absorption coefficient and acoustic impedance) of sound absorbing materials. In order to use a burst of white noise instead of individual stationary sine waves, a signal processing technique was developed. The algorithm is based on the equation of simple harmonic motion, but uses distance as a variable, instead of time. This innovative method allows measuring at frequency resolutions as low as 5 Hz in a reasonably short amount of time. This is an advantage, as the classical standing wave method uses frequency resolutions of one-third of octaves for measurements, as otherwise time would be prohibitive. Experimental results are validated with those measured with the sine wave generator using one-third of octave frequencies by comparing their behaviours.

关键词： Acoustic Impedance White Noise Sound Absorption Coefficient

Brazilian adolescents’lifestyle in the COVID‑19 pandemic:a mixed‑methods study

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World Journal of Pediatrics 2022年第8期18卷 553-557页

作者： Caroline Lima Fonseca Carolina Ferreira Peterle Bruna Hinnah Borges martins de Freitas maria Aparecida munhoz Gaíva Paula manuela Jorge diogo Juliano Bortolini Federal University of mato Grosso 2367 Fernando Corrêa da Costa AvBoa EsperançaCuiabáMT 78060-900Brazil Lisbon College of Nursing LisbonPortugal

The COVID-19 pandemic has forced the health authorities and governments worldwide to engage in a battle against the disease,adopting several mitigation strategies[1].Since then,the world population has been afected by various changes in its *** imposed by the COVID-19 pandemic are believed to have had an impact on adolescents'lifestyle(LS)[2].The LS is determined by discernible behavior patterns that can trigger efects on adolescents'health and is related to countless aspects that refect attitudes,values and life opportunities[3].Therefore,LS can be observed from the habits,behaviors and activities performed by people in their daily lives[4].

关键词： has routine COV