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[PMID]:29465542
[Au] Autor:Huang L; Huang Z; Tai Y; Wang P; Hu B; Tang C
[Ad] Endereço:Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu, China.
[Ti] Título:The small bowel diseases detected by capsule endoscopy in patients with chronic abdominal pain: A retrospective study.
[So] Source:Medicine (Baltimore);97(8):e0025, 2018 Feb.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Chronic abdominal pain (CAP) remains a particular challenge because of its complicated causes, especially when the disorders involve the small bowel, where it is quite difficult to intubate the flexible endoscopes. This study was to investigate the small bowel diseases detected by capsule endoscopy (CE) in CAP patients to evaluate the role of CE on CAP, and analyzed the relationship among the clinical characteristics of CAP patients and the positive rates of CE findings to search for the indications of CE for CAP patients.This retrospective study included 341 patients with CAP defined as recurrent abdominal pain for no <3 months. Each patient underwent CE after a negative diagnostic work-up. All CE images were reviewed by 3 gastroenterologists independently. The positive findings were defined as abnormal findings in the small bowel that might have been the causes of CAP. The final diagnosis was confirmed by CE findings, clinical features, histopathology, and a response to the treatment during the follow-up for at least 3 months after CE.The overall positive rate of CE findings was 28.15% (96/341). The positive rate in CAP-A (CAP with associated symptoms) group was significantly higher than that in CAP-O (CAP only) group (33.16% vs 21.38%, P = .017). Multivariate logistic regression analysis revealed that weight loss (odds ratio [OR] = 2.827, 95% confidence interval (CI) = 1.938-4.926), hypoalbuminemia (OR = 6.142, 95%IC = 4.129-8.274), elevated erythrocyte sedimentation rate (ESR) (OR = 4.025, 95%IC = 3.178-6.892), or increased C-reactive protein (CRP) (OR = 7.539, 95%CI = 5.365-11.723) were significantly associated with high positive rates. On follow-up, final diagnosis was confirmed in 56 of 69 (81.16%) patients with positive CE findings. About half of these patients (46.38%, 32/69) were diagnosed as inflammatory diseases, including Crohn disease (12), tuberculosis (5), NSAID enteropathy (4), etc. Tumors were proved in 21.74% (15/69) patients, including malignant in 7 cases and benign in 8 cases. Parasitosis was found in 9 (13.04%) patients.This study suggests that CE may be helpful for CAP patients to detect the small bowel diseases, half of which were comprised of inflammatory diseases. Besides, weight loss, hypoalbuminemia, elevated ESR, or increased CRP may be regarded as the indications of CE for CAP patients.
[Mh] Termos MeSH primário: Dor Abdominal/etiologia
Endoscopia por Cápsula/métodos
Dor Crônica/etiologia
Enteropatias/diagnóstico por imagem
Intestino Delgado/diagnóstico por imagem
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
Sedimentação Sanguínea
Proteína C-Reativa/análise
Feminino
Seres Humanos
Hipoalbuminemia/complicações
Modelos Logísticos
Masculino
Meia-Idade
Estudos Retrospectivos
Perda de Peso
Adulto Jovem
[Pt] Tipo de publicação:EVALUATION STUDIES; JOURNAL ARTICLE
[Nm] Nome de substância:
9007-41-4 (C-Reactive Protein)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180302
[Lr] Data última revisão:
180302
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180222
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000010025


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[PMID]:29368483
[Au] Autor:Ahmed R; Davitt J; Rayyan Y
[Ti] Título:Using Capsule Endoscopy at an Academic Teaching Hospital in West Virginia: A Descriptive Analysis of our 7 year Experience and Determination of Diagnostic Yield for Obscure Gastrointestinal Bleeding.
[So] Source:W V Med J;112(5):54-8, 2016 Sep-Oct.
[Is] ISSN:0043-3284
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Background: The aim of our study was to describe, analyze, and evaluate results of wireless capsule endoscopy (CE) as an imaging modality for various indications. Methods: We conducted a retrospective chart review study of all CE studies performed between January 1, 2007 and June 30, 2014 at Marshall University. The study included 272 patients between the ages of 21-85 years old. Results: The most common finding in our study was a normal study (57.7%) followed by small bowel erosions (14.3%), neoplasms (11.4%), Arteriovenous malformations (10.7%), inflammatory bowel disease (2.6%), and nonspecific findings (3.3%). Discussion: 90/209 patients who had indications for IDA, melena, or heme-positive stools demonstrated positive findings by CE; our diagnostic yield for obscure GI bleeding was therefore 43.1%.
[Mh] Termos MeSH primário: Endoscopia por Cápsula
Hemorragia Gastrointestinal/diagnóstico
Hospitais Universitários
[Mh] Termos MeSH secundário: Centros Médicos Acadêmicos
Adulto
Idoso
Idoso de 80 Anos ou mais
Endoscopia por Cápsula/métodos
Diagnóstico Diferencial
Feminino
Seres Humanos
Enteropatias/diagnóstico
Neoplasias do Jejuno/diagnóstico
Masculino
Meia-Idade
Valor Preditivo dos Testes
Reprodutibilidade dos Testes
Estudos Retrospectivos
Sensibilidade e Especificidade
West Virginia
[Pt] Tipo de publicação:EVALUATION STUDIES; JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180301
[Lr] Data última revisão:
180301
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180126
[St] Status:MEDLINE


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[PMID]:29364909
[Au] Autor:de Bruyn JR; Becker MA; Steenkamer J; Wildenberg ME; Meijer SL; Buskens CJ; Bemelman WA; Löwenberg M; Ponsioen CY; van den Brink GR; D'Haens GR
[Ad] Endereço:Department of Gastroenterology and Hepatology, Academic Medical Center, Amsterdam, The Netherlands.
[Ti] Título:Intestinal fibrosis is associated with lack of response to Infliximab therapy in Crohn's disease.
[So] Source:PLoS One;13(1):e0190999, 2018.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: Overt fibrostenotic disease is a relative contraindication for anti-TNF therapy in Crohn's disease. We hypothesized that subclinical fibrosis may also contribute to an incomplete response to anti-TNF therapy before the onset of symptomatic stenosis. METHODS: In a previous trial, patients with ileocecal Crohn's disease were randomized to either immediate ileocecal resection or medical treatment with Infliximab. In case of insufficient response to Infliximab, the latter underwent secondary ileocecal resection. We compared specimens from those patients undergoing immediate resection (Infliximab naïve, n = 20) to those who failed Infliximab therapy (n = 20). RESULTS: Infliximab naïve and Infliximab failure patients had similar severity of inflammation when assessed by CRP levels (median 14 vs 9 mg/L) and histology (Geboes-D'Haens-score, median 10 vs 11 points). On immunohistochemistry, collagen-III and fibronectin depositions were increased in patients previously exposed to Infliximab compared to patients naïve to Infliximab. On mRNA level, procollagen peptidase showed significantly more mucosal mRNA expression in Crohn's disease patients who failed Infliximab. Infliximab responders showed no increase of this marker after 4 weeks of successful Infliximab treatment. DISCUSSION: Failure to Infliximab therapy is associated with subclinical fibrosis in Crohn's disease.
[Mh] Termos MeSH primário: Doença de Crohn/tratamento farmacológico
Fármacos Gastrointestinais/uso terapêutico
Infliximab/uso terapêutico
Enteropatias/complicações
[Mh] Termos MeSH secundário: Adulto
Doença de Crohn/complicações
Doença de Crohn/metabolismo
Proteínas da Matriz Extracelular/metabolismo
Feminino
Fibrose
Seres Humanos
Enteropatias/metabolismo
Enteropatias/patologia
Mucosa Intestinal/enzimologia
Masculino
Meia-Idade
Pró-Colágeno N-Endopeptidase/metabolismo
Reação em Cadeia da Polimerase Via Transcriptase Reversa
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
0 (Extracellular Matrix Proteins); 0 (Gastrointestinal Agents); B72HH48FLU (Infliximab); EC 3.4.24.14 (Procollagen N-Endopeptidase)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180226
[Lr] Data última revisão:
180226
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180125
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0190999


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[PMID]:28464953
[Au] Autor:Han YM; Park JM; Choi YS; Jin H; Lee YS; Han NY; Lee H; Hahm KB
[Ad] Endereço:CHA Cancer Prevention Research Center, CHA University, CHA Bio Complex, 335 Pangyo-ro, Bundang-ku, Seongnam, Kyunggi-do, 463-712, South Korea.
[Ti] Título:The efficacy of human placenta-derived mesenchymal stem cells on radiation enteropathy along with proteomic biomarkers predicting a favorable response.
[So] Source:Stem Cell Res Ther;8(1):105, 2017 May 02.
[Is] ISSN:1757-6512
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Radiation enteropathy is a common complication in patients with abdominopelvic cancer, but no treatment has yet been established. Stem cell therapy may be a viable therapeutic option because intestinal stem cells are highly vulnerable to ionizing radiation (IR) and stem cell loss explains its intractability to general treatment. Here, we investigated either prophylactic or therapeutic efficacy of human placenta-derived mesenchymal stem cells (hPDSCs) against radiation enteropathy and could identify biomarkers predicting a favorable response to stem cell therapy. METHODS: We challenged a radiation-induced enteropathy model with hPDSCs. After sacrifice, we checked the gross anatomy of small intestine, histology gross, and analyzed that, accompanied with molecular changes implicated in this model. RESULTS: hPDSCs significantly improved the outcome of mice induced with either radiation enteropathy or lethal radiation syndrome (P < 0.01). hPDSCs exerted inhibitory actions on inflammatory cytokines, the re-establishment of epithelium homeostasis was completed with increasing endogenous restorative processes as assessed with increased levels of proliferative markers in the hPDSCs group, and a significant inhibition of IR-induced apoptosis. The preservation of cells expressing lysozyme, and Musashi-1 were significantly increased in the hPDSC treatment group. Both preventive and therapeutic efficacies of hPDSCs were noted against IR-induced enteropathy. Label-free quantification was used to identify biomarkers which predict favorable responses after hPDSC treatment, and finally glutathione S-transferase-mu type, interleukin-10, and peroxiredoxin-2 were validated as proteomic biomarkers predicting a favorable response to hPDSCs in radiation enteropathy. CONCLUSIONS: hPDSCs may be a useful prophylactic and therapeutic cell therapy for radiation enteropathy.
[Mh] Termos MeSH primário: Síndrome Aguda da Radiação/terapia
Enteropatias/terapia
Mucosa Intestinal/metabolismo
Transplante de Células-Tronco Mesenquimais/métodos
Proteoma/genética
[Mh] Termos MeSH secundário: Animais
Biomarcadores/metabolismo
Linhagem Celular
Feminino
Seres Humanos
Mucosa Intestinal/patologia
Transplante de Células-Tronco Mesenquimais/efeitos adversos
Células Mesenquimais Estromais/metabolismo
Camundongos
Camundongos Endogâmicos C57BL
Proteoma/metabolismo
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Biomarkers); 0 (Proteome)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180222
[Lr] Data última revisão:
180222
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170504
[St] Status:MEDLINE
[do] DOI:10.1186/s13287-017-0559-5


  5 / 14708 MEDLINE  
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[PMID]:28456771
[Au] Autor:Kim EK; Cho JH; Jeong AR; Kim EJ; Park DK; Kwon KA; Chung JW; Kim KO; Kim JH; Kim JH; Kim YJ
[Ad] Endereço:Division of Gastroenterology, Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Republic of Korea. yoonmed@gilhospital.com.
[Ti] Título:Anti-inflammatory effects of simvastatin in nonsteroidal anti-inflammatory drugs-induced small bowel injury.
[So] Source:J Physiol Pharmacol;68(1):69-77, 2017 Feb.
[Is] ISSN:1899-1505
[Cp] País de publicação:Poland
[La] Idioma:eng
[Ab] Resumo:Small bowel injury can occur as the result of a multifaceted process that includes increased acid secretion, generation of reactive oxygen species, and cyclooxygenase inhibition. However, no effective medication for small bowel ulceration is available. Simvastatin is an important lipid-lowering agent with anti-inflammatory activity. We aimed to validate the effects of simvastatin in vitro and in vivo. In presence or absence of simvastatin, IEC-6 small bowel cell line with 50 ng/ml of tumor nectosis factor α (TNF-α) was investigated by western blotting, qRT-PCR, and DCF-DA assay. In addition, an in vivo study of nonsteroidal anti-inflammatory drugs (NSAID)-induced small bowel inflammation was performed using 7-week-old specific-pathogen-free (SPF) male C57BL/6 mice. Simvastatin treatment reduced the mRNA levels of interleukin-6 and interleukin-8 by approximately 50% in TNF-α-stimulated IEC-6 cells. Treatment with a combination of 50 ng/ml TNF-α and µM simvastatin decreased activation of Akt, IκBα, and nuclear factor-κB p65 level in IEC-6 cells. By DCF-DA staining, intracellular reactive oxygen species (ROS) production was increased in TNF-α-stimulated cells, and treatment with simvastatin decreased the level of ROS. In addition, in vivo mouse model of NSAID-induced small bowel inflammation, the administration of simvastatin reduced the number of small bowel hemorrhagic lesions and the level of ROS production as determined by gross examination and 8-hydroxydeoxyguanosine immunohistochemistry of small bowel tissue, respectively. Simvastatin reduced NSAID-induced injuries by both suppression of ROS generation and modulation of inflammatory cytokines in vitro and in vivo. Therefore, simvastatin, an HMG-CoA reductase inhibitor, has potential as a prophylactic and therapeutic agent for NSAID-induced small bowel injury.
[Mh] Termos MeSH primário: Anti-Inflamatórios/efeitos adversos
Anti-Inflamatórios/uso terapêutico
Inibidores de Hidroximetilglutaril-CoA Redutases/uso terapêutico
Indometacina/efeitos adversos
Enteropatias/tratamento farmacológico
Intestino Delgado/lesões
Sinvastatina/uso terapêutico
[Mh] Termos MeSH secundário: Animais
Linhagem Celular
Ciclo-Oxigenase 1/genética
Ciclo-Oxigenase 2/genética
Desoxiguanosina/análogos & derivados
Desoxiguanosina/metabolismo
Inibidores de Hidroximetilglutaril-CoA Redutases/farmacologia
Interleucina-6/metabolismo
Interleucina-8/metabolismo
Enteropatias/induzido quimicamente
Enteropatias/metabolismo
Enteropatias/patologia
Intestino Delgado/metabolismo
Intestino Delgado/patologia
Masculino
Proteínas de Membrana/genética
Camundongos Endogâmicos C57BL
Inibidor de NF-kappaB alfa/metabolismo
Ratos
Espécies Reativas de Oxigênio/metabolismo
Sinvastatina/farmacologia
Fator de Necrose Tumoral alfa/metabolismo
Fator de Necrose Tumoral alfa/farmacologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anti-Inflammatory Agents); 0 (Hydroxymethylglutaryl-CoA Reductase Inhibitors); 0 (Interleukin-6); 0 (Interleukin-8); 0 (Membrane Proteins); 0 (Reactive Oxygen Species); 0 (Tumor Necrosis Factor-alpha); 139874-52-5 (NF-KappaB Inhibitor alpha); 88847-89-6 (8-oxo-7-hydrodeoxyguanosine); AGG2FN16EV (Simvastatin); EC 1.14.99.1 (Cyclooxygenase 1); EC 1.14.99.1 (Cyclooxygenase 2); EC 1.14.99.1 (Ptgs1 protein, rat); EC 1.14.99.1 (Ptgs2 protein, rat); G9481N71RO (Deoxyguanosine); XXE1CET956 (Indomethacin)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180220
[Lr] Data última revisão:
180220
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170501
[St] Status:MEDLINE


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[PMID]:27777142
[Au] Autor:Fløisand Y; Lundin KEA; Lazarevic V; Kristiansen JD; Osnes LTN; Tjønnfjord GE; Reims HM; Gedde-Dahl T
[Ad] Endereço:Department of Hematology, Oslo University Hospital, Rikshospitalet, Oslo, Norway. Electronic address: yfl70@me.com.
[Ti] Título:Targeting Integrin α4ß7 in Steroid-Refractory Intestinal Graft-versus-Host Disease.
[So] Source:Biol Blood Marrow Transplant;23(1):172-175, 2017 Jan.
[Is] ISSN:1523-6536
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Steroid refractory acute graft-versus-host-disease of the gut is a serious complication associated with high mortality after allogeneic stem cell transplantation. Treatment options are limited and not predictably effective. We describe the treatment of steroid-refractory acute graft-versus-host-disease with vedolizumab, an antibody directed against integrin α4ß7, in 6 patients. All patients responded, and 4 of 6 patients are alive with a median follow-up of 10 months.
[Mh] Termos MeSH primário: Anticorpos Monoclonais Humanizados/uso terapêutico
Doença Enxerto-Hospedeiro/tratamento farmacológico
Integrinas/efeitos dos fármacos
Enteropatias/tratamento farmacológico
[Mh] Termos MeSH secundário: Adulto
Feminino
Fármacos Gastrointestinais/uso terapêutico
Doença Enxerto-Hospedeiro/patologia
Transplante de Células-Tronco Hematopoéticas/efeitos adversos
Seres Humanos
Masculino
Meia-Idade
Terapia de Salvação/métodos
Esteroides/uso terapêutico
Transplante Homólogo
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antibodies, Monoclonal, Humanized); 0 (Gastrointestinal Agents); 0 (Integrins); 0 (Steroids); 0 (integrin alpha4beta7); 9RV78Q2002 (vedolizumab)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180213
[Lr] Data última revisão:
180213
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161026
[St] Status:MEDLINE


  7 / 14708 MEDLINE  
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[PMID]:29281659
[Au] Autor:Mwape I; Bosomprah S; Mwaba J; Mwila-Kazimbaya K; Laban NM; Chisenga CC; Sijumbila G; Simuyandi M; Chilengi R
[Ad] Endereço:Center for Infectious Disease Research in Zambia, Lusaka, Zambia.
[Ti] Título:Immunogenicity of rotavirus vaccine (RotarixTM) in infants with environmental enteric dysfunction.
[So] Source:PLoS One;12(12):e0187761, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: Deployment of rotavirus vaccines has contributed to significant declines in diarrheal morbidity and mortality globally. Unfortunately, vaccine performance in low-middle income countries (LMICs) is generally lower than in developed countries. The cause for this has been associated with several host and maternal factors including poor water sanitation and hygiene (WASH) status, which are predominant in LMICs. More recently, environmental enteric dysfunction (EED) has specifically been hypothesized to contribute to poor vaccine uptake and response. The aim of this study was to examine the association between serological biomarkers of EED and seroconversion to rotavirus vaccine in Zambian infants. METHODS: This was a retrospective cohort study of 142 infants who had been fully immunized with Rotarix™, and had known seroconversion status. Seroconversion was defined as 4-fold or more increase in rotavirus-specific IgA titres between pre-vaccination and one month post-dose two vaccination. We performed ELISA assays to assess soluble CD14 (sCD14), Endotoxin Core IgG Antibodies (EndoCAb), intestinal fatty acid binding protein (i-FABP) and Zonulin according to the manufacturers protocols. Generalised linear model with family-poisson, link-log and robust standard error was used to estimate the independent effects of biomarkers on seroconversion adjusting for important cofounders. RESULTS: The median concentration of Zonulin, Soluble CD14, EndoCaB, and IFABP were 209.3 (IQR = 39.7, 395.1), 21.5 (IQR = 21.5, 21.5), 0.3 (IQR = 0.3, 0.3), and 107.7 (IQR = 6.4, 1141.4) respectively. In multivariable analyses adjusting for the independent effect of other biomarkers and confounders (i.e. age of child at vaccination, breast-milk anti-rotavirus IgA, infant serum anti-rotavirus IgG, and IgA seropositivity at baseline), there was strong evidence of about 24% increase in seroconversion due to doubling Zonulin concentration (Adjusted risk ratio (aRR) = 1.24; 95% CI = 1.12 to1.37; p<0.0001). Similarly, we found about 7% increase in seroconversion due to doubling IFABP concentration (aRR = 1.07; 95% CI = 1.02 to 1.13; p = 0.006). CONCLUSION: We found that high levels of zonulin and IFABP played a role in seroconversion. It is plausible that increased gut permeability in EED allows greater uptake of the live virus within the vaccine, but later consequences result in deleterious local structural distortions and malabsorption syndromes.
[Mh] Termos MeSH primário: Enteropatias/imunologia
Vacinas contra Rotavirus/imunologia
[Mh] Termos MeSH secundário: Anticorpos Antivirais/biossíntese
Anticorpos Antivirais/imunologia
Biomarcadores/sangue
Ensaio de Imunoadsorção Enzimática
Proteínas de Ligação a Ácido Graxo/imunologia
Feminino
Seres Humanos
Imunoglobulina A/sangue
Imunoglobulina G/sangue
Lactente
Receptores de Lipopolissacarídeos/imunologia
Masculino
Estudos Retrospectivos
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, N.I.H., EXTRAMURAL; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
0 (Antibodies, Viral); 0 (Biomarkers); 0 (Fatty Acid-Binding Proteins); 0 (Immunoglobulin A); 0 (Immunoglobulin G); 0 (Lipopolysaccharide Receptors); 0 (Rotavirus Vaccines)
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180129
[Lr] Data última revisão:
180129
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171228
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0187761


  8 / 14708 MEDLINE  
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[PMID]:29310410
[Au] Autor:Zhou Y; Wang F; Ji Y; Lv J
[Ad] Endereço:People Hospital of Jingjiang, Medical School of YangZhou University.
[Ti] Título:A CARE-compliant article: a case of retrograde intussusception with Uncut-Roux-en-Y anastomosis after radical total gastrectomy: Review of the literature.
[So] Source:Medicine (Baltimore);96(48):e8982, 2017 Dec.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Postoperative intussusception is an unusual clinical entity and is rarely encountered as a complication following gastrectomy, especially radical total gastrectomy. PATIENT CONCERNS: A 74-year-old woman was admitted to our hospital with complaints of melena and hematemesis. And the endoscopic biopsy confirmed the poorly differentiated adenocarcinoma of the stomach. Radical total gastrectomy with Uncut Roux-en-Y reconstruction was performed. On the third postoperative day (POD3), the patient complained of paroxysmal pain around the umbilicus, accompanied by nausea and vomiting. DIAGNOSIS: Retrograde intussusceptions after radical total gastrectomy with Uncut Roux-en-Y reconstruction based on exploratory laparotomy. INTERVENTIONS: On POD4, the abdominal computed tomography (CT) showed small bowel dilatation and fluid accumulation in the upper abdominal cavity, as well as a small mass of soft tissue on the left side of the pelvis. Small bowel obstruction was considered, and exploratory laparotomy was performed. Retrograde intussusception started just below the jejunojejunal anastomosis with possible organic lesions, which was subsequently removed. OUTCOMES: The patient recovered well and was discharged 15 days after the second operation. LESSONS: This case report was written for 3 purposes: to increase awareness of this complication after radical total gastrectomy with Uncut-Roux-en-Y reconstruction; to emphasize early diagnosis through clinical manifestation, physical examination, and auxiliary examination with abdominal CT; and lastly, to emphasize that a reasonable surgical procedure should be performed immediately after diagnosis.
[Mh] Termos MeSH primário: Anastomose em-Y de Roux
Gastrectomia
Enteropatias/etiologia
Intussuscepção/etiologia
Complicações Pós-Operatórias
[Mh] Termos MeSH secundário: Adenocarcinoma/diagnóstico por imagem
Adenocarcinoma/cirurgia
Idoso
Feminino
Seres Humanos
Enteropatias/diagnóstico por imagem
Enteropatias/cirurgia
Intussuscepção/diagnóstico por imagem
Intussuscepção/cirurgia
Neoplasias Gástricas/diagnóstico por imagem
Neoplasias Gástricas/cirurgia
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180116
[Lr] Data última revisão:
180116
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180110
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000008982


  9 / 14708 MEDLINE  
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Monteiro, Hugo Pequeno
Texto completo SciELO Brasil
[PMID]:29236798
[Au] Autor:Oliveira TRR; Oliveira GF; Simões RS; Feitosa SM; Tikazawa EH; Monteiro HP; Fagundes DJ; Taha MO
[Ad] Endereço:PhD, Associate Professor, School of Health Sciences, Universidade Federal da Grande Dourados (UFGD), Brazil. Acquisition, analysis and interpretation of data; technical procedures; statistical analysis; manuscript preparation and writing.
[Ti] Título:The expression of endothelial and inducible nitric oxide synthase and apoptosis in intestinal ischemia and reperfusion injury under the action of ischemic preconditioning and pentoxifylline.
[So] Source:Acta Cir Bras;32(11):935-948, 2017 Nov.
[Is] ISSN:1678-2674
[Cp] País de publicação:Brazil
[La] Idioma:eng
[Ab] Resumo:PURPOSE: To investigate the expression of nitric oxide synthase (NOS) and apoptosis associated with ischemic preconditioning (IPC) and pentoxifylline (PTX) in intestinal ischemia (I) and reperfusion (R) injury. METHODS: Thirty male rats were assigned to 5 groups: (CG), no clamping of the superior mesenteric artery (90 minutes); (IR-SS) saline + ischemia (30 minutes) + reperfusion (60 minutes); (IR-PTX) PTX + ischemia (30 minutes) + reperfusion (60 minutes); (IPC-IR-SS) 5 minutes of ischemia + 5 minutes of reperfusion (IPC) + saline + I(30 minutes)+R(60 minutes); and (IPC-IR-PTX) IPC + PTX + I(30 minutes)+ R(60 minutes). RESULTS: The application of IPC and PTX showed a significantly lower immunohistochemistry reaction for active caspase-3 (P<0.05) compared to IR+SS. The number of cells immunoreactive to BCL-2 was higher in the IR-PTX group (P>0.05). The NOS-2 expression (qRTPCR) in the IR-PTX group (P<0.05) was higher than the values for the IPC+IR-SS and IPC-IR-PTX groups. The NOS-3 expression was significantly upper in the IPC-IR-PTX group than in the CG (P<0.05), the IR-SS (P<0.05) and the IR-PTX (P<0.05) groups. CONCLUSIONS: The BCL-2 and active caspase-3 showed beneficial effects on PTX and IPC. The expression of NOS-2 and NOS-3 in the IPC and IPC-PTX groups showed no synergistic effect.
[Mh] Termos MeSH primário: Apoptose/efeitos dos fármacos
Enteropatias/prevenção & controle
Intestinos/irrigação sanguínea
Precondicionamento Isquêmico
Óxido Nítrico Sintase/metabolismo
Pentoxifilina/uso terapêutico
[Mh] Termos MeSH secundário: Animais
Apoptose/fisiologia
Modelos Animais de Doenças
Seres Humanos
Imuno-Histoquímica
Enteropatias/enzimologia
Intestinos/patologia
Masculino
RNA Mensageiro/análise
Ratos
Ratos Wistar
Vasodilatadores/uso terapêutico
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (RNA, Messenger); 0 (Vasodilator Agents); EC 1.14.13.39 (Nitric Oxide Synthase); SD6QCT3TSU (Pentoxifylline)
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171220
[Lr] Data última revisão:
171220
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171214
[St] Status:MEDLINE


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Texto completo
[PMID]:29229114
[Au] Autor:Fantozzi ET; Breithaupt-Faloppa AC; Ricardo-da-Silva FY; Rodrigues-Garbin S; Romero DC; da Silva Rodrigues A; Riffo-Vasquez Y; Tavares-de-Lima W
[Ad] Endereço:Department of Pharmacology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil.
[Ti] Título:Estradiol mediates the long-lasting lung inflammation induced by intestinal ischemia and reperfusion.
[So] Source:J Surg Res;221:1-7, 2018 Jan.
[Is] ISSN:1095-8673
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Lung inflammation is one of the main consequences of intestinal ischemia reperfusion (intestinal IR) and, in severe cases, can lead to acute respiratory distress syndrome and death. We have previously demonstrated that estradiol exerts a protective effect on lung edema and cytokine release caused by intestinal IR in male rats. MATERIALS AND METHODS: We investigated the role of estradiol on the generation of interleukin (IL)-1ß, IL-10, vascular endothelial growth factor (VEGF), and cytokine-induced neutrophil chemoattractant 1 (CINC-1) in a female rat model of intestinal IR. Blood and bone marrow leukocytes were also quantified. Seven-days-ovariectomized rats were subjected to intestinal IR by occlusion of the superior mesenteric artery for 45 min. After reperfusion of the tissue for 2 h, the rats were sacrificed. Lung tissue was collected, cultured for 24 h and assayed. RESULTS: We observed a significant increase in serum levels of IL-10, CINC-1, uric acid and circulating, but not bone marrow, leukocyte numbers. In addition, intestinal IR induced a significant increase in the ex-vivo lung levels of IL-1ß, IL-10, and VEGF. Treatment with 17ß-estradiol before the induction of intestinal IR prevented the systemic release of IL-10, CINC-1, and uric acid, but it did not affect the leukocytosis. In addition, 17ß-estradiol significantly prevented the ex-vivo release of IL-1ß and VEGF from lung tissue. CONCLUSIONS: We demonstrated that intestinal IR interferes with lung homeostasis, priming the tissue to generate proinflammatory mediators for at least 24 h postischemia. Furthermore, our data confirm that the inflammatory responses caused by intestinal IR are estradiol mediated.
[Mh] Termos MeSH primário: Estradiol/fisiologia
Enteropatias/complicações
Intestinos/irrigação sanguínea
Pneumopatias/etiologia
Traumatismo por Reperfusão/complicações
[Mh] Termos MeSH secundário: Animais
Citocinas/sangue
Feminino
Enteropatias/sangue
Contagem de Leucócitos
Pulmão/metabolismo
Pneumopatias/sangue
Ratos Wistar
Traumatismo por Reperfusão/sangue
Ácido Úrico/sangue
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Cytokines); 268B43MJ25 (Uric Acid); 4TI98Z838E (Estradiol)
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171220
[Lr] Data última revisão:
171220
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171213
[St] Status:MEDLINE



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