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Noninvasive methods for prediction of esophageal varices in pediatric patients with portal hypertension

World Journal of Gastroenterology 2013年第13期19卷 2053-2059页

作者： Marina Rossato Adami Cristina Targa Ferreira Carlos Oscar Kieling Vania Hirakata sandra maria gonalves vieira Universidade Federal do Rio Grande do Sul Post-Graduation in Gastroenterology and HepatologyHospital de Clínicas de Porto Alegre

AIM: To evaluate clinical and laboratory parameters for prediction of bleeding from esophageal varices (EV) in children with portal hypertension. METHODS: Retrospective study of 103 children (mean age: 10.1 ± 7.7 years), 95.1% with intrahepatic portal hypertension. All patients had no history of bleeding and underwent esophagogastroduodenoscopy for EV screening. We recorded variceal size (F1, F2 and F3), red-color signs and portal gastropathy, according to the Japanese Research Society for Portal Hypertension classification. Patients were classified into two groups: with and without EV. Seven noninvasive markers were evaluated as potential predictors of EV: (1) platelet count; (2) spleen size z score, expressed as a standard deviation score relative to normal values for age; (3)platelet count to spleen size z score ratio; (4) platelets count to spleen size (cm) ratio; (5) the clinical prediction rule (CPR); (6) the aspartate aminotransferase to platelet ratio index (APRI); and (7) the risk score. RESULTS: Seventy-one children had EV on first endoscopy. On univariate analysis, spleen size, platelets, CPR, risk score, APRI, and platelet count to spleen size z score ratio showed significant associations. The best noninvasive predictors of EV were platelet count [area under the receiver operating characteristic curve (AUROC) 0.82; 95%CI: 0.73-0.91], platelet: spleen size z score (AUROC 0.78; 95%CI: 0.67-0.88), CPR (AUROC 0.77; 95%CI: 0.64-0.89), and risk score (AUROC 0.77; 95%CI: 0.66-0.88). A logistic regression model was applied with EV as the dependent variable and corrected by albumin, bilirubin and spleen size z score. Children with a CPR 114. A risk score > -1.2 increased the likelihood of EV (odds ratio 7.47; 95%CI: 2.06-26.99). CONCLUSION: Children with portal hypertension with a CPR below 114 and a risk score greater than -1.2 are more likely to have present EV. Therefore, these two tes

关键词： Portal hypertension Clinical predictors Pediatric patients Esophageal varices

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Update of the spectrum of mucopolysaccharidoses type Ⅲ in Tunisia: identification of three novel mutations and in silico structural analysis of the missense mutations

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World Journal of Pediatrics 2017年第4期13卷 374-380页

作者： Souad Ouesleti maria Francisca Coutinho Isaura Ribeiro Abdehedi Miled Dalila Saidane Mosbahi sandra alves Biochemical Service CHU Farhat Hached4000SousseTunisia Research and Development Unit Department of Human GeneticsNational Institute of Health Dr.Ricardo JorgePortoPortugal Biochemical Genetics Unit Medical Genetics Center Dr.Jacinto de Magalh(a)esPorto Hospital CentrePortoPortugal Laboratory of Analysis Treatment and Valorization of Pollutants of the Environment and ProductsFaculty of PharmacyUniversity of Monastir5000Tunisia

Background:Mucopolysaccharidoses type Ⅲ (MPS Ⅲ) are a group of autosomai recessive lysosomal storage diseases,caused by mutations in genes that code for enzymes involved in the lysosomal degradation of heparan sulphate:heparan sulfate sulfamidase (SGSH),a-N-acetylglucosaminidase (NAGLU),heparan sulfate acetyl-CoA:a-glucosaminide N-acetyltransferase (HGSNAT),and N-acetylglucosamine-6-sulfatase (GNS).Methods:In this study,we have performed the molecular analysis of the SGSH,NAGLU and HGSNAT genes in 10 patients from 6 different MPS Ⅲ Tunisian ***:In the SGSH gene,two mutations were identified:one novel (p.D477N) and one already described (p.Q365X).In the NAGLU gene,two novel mutations were discovered (p.L550P and p.E153X).For the novel missense mutations found in these two genes we performed an in silico structural analysis and the results were consistent with the clinical course of the patients harboring those ***,in HGSNAT gene,we found the splicesite mutation c.234+1G>A that had already been reported as relatively frequent in MPS ⅢC patients from countries surrounding the basin of the Mediterranean *** presence in two Tunisian MPS ⅢC families points to the hypothesis of its peri Mediterranean *** the exception of the c.234+1G>A mutation,that was identified in two unrelated MPS ⅢC families,the other identified mutations were family-specific and were always found in homozygosity in the patients studied,thus reflecting the existence of consanguinity in MPS Ⅲ Tunisian ***:Three novel mutations are reported here,further contributing to the knowledge of the molecular basis of these *** results of this study will allow carrier detection in affected families and prenatal molecular diagnosis,leading to an improvement in genetic counseling.

关键词： molecular characterization mucopolysaccharidosis Ⅲ mutation

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Antihyperglycemic effect of Passiflora glandulosa cav. fruit rinds flour in streptozotocin-induced diabetic mice

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Asian Pacific Journal of Tropical Medicine 2018年第9期11卷 510-517页

作者： Erlandia alves Magalhaes Queiroz Raquel Teixeira Terceiro Paim sandra Machado Lira Jose Ytalo Gomes da Silva Carla Laine Silva Lima Marcelo Oliveira Holanda Stephen Rathinaraj Benjamin Icaro Gusmao Pinto vieira maria Izabel Florindo Guedes Biotechnology and Molecular Biology Laboratory State University of CearaFortaleza Ceara Brazil Technological Development Park(PADETEC) Federal University of CearaPici Campus Fortaleza Ceara Brazil

Objective:To investigate the effect of administration of Passiflora glandulosa(***) fruit rinds flour on streptozotocin(STZ)-induced diabetic ***:The preliminary phytochemical screening and parameters such as centesimal composition and brine shrimp toxicity were *** in vivo study Swiss female mice were divided into four groups:NC-normal control;DC-diabetic control animals receiving saline;MET-diabetic animals receiving metformin(200 mg/kg);PFRF-diabetic animals receiving *** fruit rinds flour(200 mg/kg).All of them were treated for 28 *** was used in a single dose of 120 mg/kg to establish diabetic *** weight,water and food intake,fasting blood glucose were *** analysis of pancreas and liver were performed to evaluate STZ-induced tissue ***:Phytochemical screening showed the presence of flavanones and *** *** fruit rinds flour was non-toxic by the brine shrimp *** fruit rinds flour also reduced the loss of body weight and significantly decreased food intake in the diabetic ***,a significant reduction in blood glucose was observed for 15 d and this was maintained on 21 d and 28 d when compared with diabetic ***,the *** fruit rinds flour has a favourable effect on the histopathological changes of the pancreas in STZ induced ***:It is concluded that *** fruit rinds flour is a natural product that contains potent antioxidant compounds and presents good prospects for the improvement of diabetic mellitus by reducing serum glucose levels.

关键词： Diabetes mellitus Passiflora Blood glucose Histology Streptozotocin Mice

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Tocotrienol isoforms:The molecular mechanisms underlying their effects in cancer therapy and their implementation in clinical trials

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Journal of Integrative Medicine 2024年第1期22卷 1-11页

作者： maria Younes Ghady Loubnane Christopher Sleiman sandra Rizk Department of Natural Sciences Lebanese American UniversityByblosLebanon

Tocotrienols are found in a variety of natural sources,like rice bran,annatto seeds and palm oil,and have been shown to have several health-promoting properties,particularly against chronic diseases such as *** incidence of cancer is rapidly increasing around the world,not only a result of continued aging and population growth,but also due to the adoption of aspects of the Western lifestyle,such as high-fat diets and low-physical *** literature provides strong evidence that tocotrienols are able to inhibit the growth of various cancers,including breast,lung,ovarian,prostate,liver,brain,colon,myeloma and pancreatic *** findings,along with the reported safety profile of tocotrienols in healthy human volunteers,encourage further research into these compounds’potential use in cancer prevention and *** current review provided detailed information about the molecular mechanisms of action of different tocotrienol isoforms in various cancer models and evaluated the potential therapeutic effects of different vitamin E analogues on important cancer hallmarks,such as cellular proliferation,apoptosis,angiogenesis and ***/PubMed and Scopus databases were used to identify recently published articles that investigated the anticancer effects of vitamin E derivatives in various types of cancer in vitro and in vivo along with clinical evidence of adjuvant chemopreventive *** an overview of pre-clinical studies,we describe several completed and ongoing clinical trials that are paving the way for the successful implementation of tocotrienols in cancer chemotherapy.

关键词： Vitamin E Tocotrienols Cancer Molecular mechanism Clinical trials

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In search for novel strategies towards neuroprotection and neuroregeneration: is PPARα a promising therapeutic target?

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Neural Regeneration Research 2015年第9期10卷 1409-1412页

作者： sandra Moreno maria Paola Cerù Department of Science-LIME University Roma Tre Department of Life Health and Environmental Sciences University of L’AquilaCoppito (AQ) Italy

Peroxisome proliferator activated receptors： In the early 1990s, seminal work on rodent liver demonstrated that the hypolipidemic effect of xenobiotics, referred to as peroxisome proliferators, was mediated by a member of steroid hormone receptor superfamily, thus designated peroxisome proliferator-activated receptors （PPARs）（Issemann and Green, 1990; Dreyer et al., 1992）. The research field opened by this discovery led to the identification of three isotypes, namely PPARa （NR1C1）, PPAR[3/6 （NRIC2）, PPARy （NRIC3）, in a wide range of tissues. All these receptors act as ligand-activated transcription factors, binding lipid molecules with different, though overlapping, specificity.

关键词： PPAR a promising therapeutic target is PPAR

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Uncoupling protein 2 deficiency reduces proliferative capacity of murine pancreatic stellate cells

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Hepatobiliary & Pancreatic Diseases International 2016年第6期15卷 647-654页

作者： Sarah Muller sandra maria Klingbeil Andreea Sandica Robert Jaster Department of Medicine II Division of Gastroen-terologyRostock University Medical CenterE.-Heydemann-Str.618057 RostockGermany

BACKGROUND： Uncoupling protein 2 （UCP2） has been suggested to inhibit mitochondrial production of reactive oxygen species （ROS） by decreasing the mitochondrial membrane potential. Experimental acute pancreatitis is associated with increased UCP2 expression, whereas UCP2 deficiency retards regeneration of aged mice from acute pancreatitis. Here, we have addressed biological and molecular functions of UCP2 in pancreatic stellate cells （PSCs）, which are involved in pancreatic wound repair and fibrogenesis. METHODS： PSCs were isolated from 12 months old （aged） UCP2^-/- mice and animals of the wild-type （WT） strain C57BL/6. Proliferation and cell death were assessed by em- ploying trypan blue staining and a 5-bromo-2＇-deoxyuridine incorporation assay. Intracellular fat droplets were visualized by oil red O staining. Levels of mRNA were determined by RT-PCR, while protein expression was analyzed by immunoblotting and immunofluorescence analysis. Intracellular ROS levels were measured with 2＇,7＇-dichlorofluorescin diacetate. Expression of senescence-associated β-galactosidase （SA β-Gal） was used as a surrogate marker of cellular senescence. RESULTS： PSCs derived from UCP2^-/- mice proliferated at a lower rate than cells from WT mice. In agreement with this observation, the UCP2 inhibitor genipin displayed dose- dependent inhibitory effects on WT PSC growth. Interestingly, ROS levels in PSCs did not differ between the two strains, and PSCs derived from UCP2^-/- mice did not senesce faster than those from corresponding WT cells. PSCs from UCP2^-/- mice and WT animals were also indistinguishable with respect to the activation-dependent loss of intracellular fat droplets, expression of the activation marker α-smooth muscle actin, type I collagen and the autocrine/paracrine mediators interleukin-6 and transforming growth factor-I~ 1. CONCLUSIONS： A reduced proliferative capacity of PSC from aged UCP2^-/- mice may contribute to the retarded regeneration after acute pancreatitis.

关键词： pancreatitis proliferation stellate cell biology uncoupling protein 2

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Impact of technology use in type 2 diabetes distress:A systematic review

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World Journal of Diabetes 2020年第10期11卷 459-467页

作者： Patricia vieira Renata Kobayasi Filomena Pereira Isabella Martins Zaia sandra Umeda Sasaki Department of Health Iron SaúdeAlcabideche 2649-517Portugal Department of Internal Medicine University of Sao PauloSao Paulo 05410-020Brazil School of Psychology and Science of Education University of PortoPorto 4200-465Portugal Medical School UNICID Sao Paulo 03071-000Brazil

BACKGROUND Diabetes distress is an important factor in treatment outcomes and results in poor behavioral and biological *** has been used in management programs of diabetes to improve communication between patients and health care providers and to promote education about the disease and its psychological aspects,which can impact the self-efficacy of the ***,the true impact of technological approaches on the management of type 2 diabetes distress remains *** To investigate the effectiveness of technology interventions on the management of type 2 diabetes *** Studies published from 2014 to 2019 were searched in five databases:MEDLINE,PubMed,Library and Information Science Source,Academic Search Ultimate and *** Boolean logic search terms were:(1)T2Diabetes;(2)diabetes distress;and(3)technology OR mobile OR phone OR application OR *** also systematically searched the reference lists of the included studies and relevant *** controlled trials with technology interventions,type 2 diabetes patients and diabetes distress as the outcome were *** Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement was *** Of the 88 studies selected,nine full articles met the inclusion criteria and were subjected to final careful *** the JADAD scale,one article was classified as having poor quality and eight as having good *** out of nine articles showed that technology interventions had a positive impact on diabetes distress scale scores when compared with the initial *** the six articles,five showed a greater reduction in the diabetes distress scores from control ***-based interventions had good results when users received personalized feedback and routine caregiver support and *** Technology interventions can contribute positively to the management of type 2 diabetes distress,especially with a tailored appro

关键词： Technology Type 2 diabetes Diabetes distress Healthcare Systematic review

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Serum proinflammatory cytokines and nutritional status in pediatric chronic liver disease

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World Journal of Gastroenterology 2015年第29期21卷 8927-8934页

作者： Daniele Santetti maria Inês de Albuquerque Wilasco Cristina Toscani Leal Dornelles Isabel Cristina Ribas Werlang Fernanda Urruth Fontella Carlos Oscar Kieling Jorge Luiz dos Santos sandra maria goncalves vieira Helena Ayako Sueno Goldani Post-Graduate Program of Child and Adolescent Health Faculdade de MedicinaUniversidade Federal do Rio Grande do SulPorto Alegre Nutrition Service Hospital de Clínicas de Porto AlegreUniversidade Federal do Rio Grande do SulPorto Alegre Laboratory of Translational Pediatrics-NESCA Hospital de Clínicas de Porto AlegreUniversidade Federal do Rio Grande do SulPorto Alegre Pediatric Hepatology Unit Hospital de Clínicas de Porto AlegreUniversidade Federal do Rio Grande do SulPorto Alegre Pediatric Gastroenterology Unit Hospital de Clínicas de Porto Alegre and Post-Graduate Program of Child and Adolescent HealthFaculdade de MedicinaUniversidade Federal do Rio Grande do SulPorto Alegre

AIM: To evaluate the nutritional status and its association with proinflammatory cytokines in children with chronic liver ***: We performed a cross-sectional study with 43 children and adolescents, aged 0 to 17 years, diagnosed with chronic liver disease. All patients regularly attended the Pediatric Hepatology Unit and were under nutritional follow up. The exclusion criteria were fever from any etiology at the time of enrollment, inborn errors of the metabolism and any chronic illness. The severity of liver disease was assessed by Child-Pugh, Model for End-stage Liver Disease(MELD) and Pediatric End Stage Liver Disease(PELD) scores. Anthropometric parameters were height/age, body mass index/age and triceps skinfold/age according to World Health Organization standards. The cutoff points for nutritional status were risk of malnutrition(Z-score <-1.00) and malnutrition(Z-score <-2.00). Interleukin-1β(IL-1β), IL-6 and tumor necrosis factor-α levels were assessed by commercial ELISA kits. For multivariate analysis, linear regression was applied to assess the association between cytokine levels, disease severity and nutritional status. RESULTS: The median(25th-75 th centile) age of the study population was 60(17-116)-mo-old, and 53.5% were female. Biliary atresia was the main cause of chronic liver disease(72%). With respect to Child-Pugh score, cirrhotic patients were distributed as follows: 57.1% Child-Pugh A, a mild presentation of the disease, 34.3% Child-Pugh B, a moderate stage of cirrhosis and 8.6% Child-Pugh C, were considered severe cases. PELD and MELD scores were only above the cutoff point in 5 cases. IL-6 values were increased in patients at nutritional risk(34.9%) compared with those who were well-nourished [7.12(0.58-34.23) pg/m L vs 1.63(0.53-3.43) pg/m L; P = 0.02], correlating inversely with triceps skinfold-for-age z-score(rs =-0.61; P < 0.001). IL-6 levels were associated with liver disease severity assessed by Child-Pugh score(P = 0.001).

关键词： Cytokines Interleukin-6 Malnutrition Cirrhosis Child

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Metabolic and nutritional triggers associated with increased risk of liver complications in SARS-CoV-2

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World Journal of Hepatology 2022年第1期14卷 80-97页

作者： Rosangela Passos de Jesus Jozélio Freire de Carvalho Lucivalda Pereira Magalhães de Oliveira Carla de Magalhães Cunha Thaisy Cristina Honorato Santos alves sandra Tavares Brito vieira Virginia maria Figueiredo Allain Amador Bueno Postgraduate Program in Food Nutrition and Health at the School of Nutrition of the Federal University of BahiaSalvador 40.110-150BahiaBrazil Institute of Health Sciences Federal University of BahiaSalvador 40231-300BahiaBrazil Institute of Life Sciences State University of BahiaSalvador 41.150-000BahiaBrazil Department of Gastroenterology IPEMEDIpemed Faculty of Medical SciencesSalvador 40170-110BahiaBrazil College of Health Life and Environmental SciencesUniversity of WorcesterWorcester WR26AJUnited Kingdom

Obesity,diabetes,cardiovascular and respiratory diseases,cancer and smoking are risk factors for negative outcomes in severe acute respiratory syndrome coronavirus 2(SARS-CoV-2),which can quickly induce severe respiratory failure in 5%of *** disease-associated liver injury may occur during progression of SARS-CoV-2 in patients with or without pre-existing liver disease,and damage to the liver parenchyma can be caused by infection of *** patients may be particularly vulnerable to SARS-CoV-2 if suffering with cirrhosis-associated immune ***,pharmacotherapies including macrolide or quinolone antibiotics and steroids can also induce liver *** this review we addressed nutritional status and nutritional interventions in severe SARS-CoV-2 liver *** guidelines for SARS-CoV-2 in intensive care(IC)specifically are not yet available,strategies for management of sepsis and SARS are suggested in *** enteral nutrition(EN)should be started soon after IC admission,preferably employing iso-osmolar polymeric formula with initial protein content at 0.8 g/kg per day progressively increasing up to 1.3 g/kg per day and enriched with fish oil at 0.1 g/kg per day to 0.2 g/kg per *** is necessary to identify signs of intolerance,hemodynamic instability and metabolic disorders,and transition to parenteral nutrition should not be delayed when energy and protein targets cannot be met via *** including vitamins A,C,D,E,B6,B12,folic acid,zinc,selenium andω-3 fatty acids have in isolation or in combination shown beneficial effects upon immune function and inflammation *** and monitored supplementation up to upper limits may be beneficial in management strategies for SARS-CoV-2 liver patients.

关键词： COVID-19 SARS-CoV-2 Enteral nutrition Parenteral nutrition Hepatic failure

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Evaluation of parasitemia by qPCR in patients with chronic Chagas disease treated with benznidazole

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Asian Pacific Journal of Tropical Medicine 2023年第12期16卷 565-572页

作者： Tycha Bianca Sabaini Pavan Eros Antônio de Almeida Rodrigo gonçalves de Lima Jamiro da Silva Wanderley Luiz Cláudio Martins sandra Cecília Botelho Costa Gláucia Elisete Barbosa Marcon Departamento de Clínica Médica Faculdade de Ciências MédicasUniversidade Estadual de Campinas(Unicamp)CampinasSão PauloBrasil Fundação Oswaldo Cruz Fiocruz Mato Grosso do SulCampo GrandeMSBrasil

Objective:To evaluate parasitemia by qPCR in patients undergoing etiological treatment and followed in a Brazilian reference ***:Parasite load was quantified by qPCR in 32 participants with chronic Chagas disease who were treated with *** analyses were performed before and after the treatment and parasite loads were compared prior and 12/18 months post the ***:Thirty-two participants were recruited and treated with benznidazole,and 20 were *** events(AE)were observed in 22 out of 29 participants that had safety data(76%),and dermatological alterations were the most frequently observed *** the 20 participants analyzed,13 and 7 completed 12 and 18 months follow-up after the treatment,respectively.12 Months after the final treatment,Trypanosoma cruzi was detectable in 3 patients by qPCR;18 months after the final treatment,Trypanosoma cruzi was detectable per qPCR in 4 of the 7 ***,between 12 and 18 months,7 participants of the 20 initial follow-up cases showed positive qPCR,indicating treatment ***:qPCR can be used as an alternative method for evaluating the effectiveness of the etiological treatment of CD,and can be applied to analyze early therapeutic *** study showed that benznidazole therapy had limited effectiveness in treating chronic CD patients,thus emphasizing the importance of conducting continued research for developing more effective therapies and diagnosis for CD.

关键词： Trypanosoma cruzi Chagas disease Antitrypanosomal therapy Benznidazole qPCR Therapeutic failure

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