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| 1 | Epidemiology, demographic characteristics and prognostic predictors of ulcerative colitis显示文摘Ulcerative colitis(UC)is a chronic disease characterized by diffuse inflammation of the mucosa of the colon and rectum.The hallmark clinical symptom of UC is bloody diarrhea.The clinical course is marked by exacerbations and remissions,which may occur spontaneously or in response to treatment changes or intercurrent illnesses.UC is most commonly diagnosed in late adolescence or early adulthood,but it can occur at any age.The incidence of UC has increased worldwide over recent decades,especially in developing nations.In contrast,during this period,therapeutic advances have improved the life expectancy of patients,and there has been a decrease in the mortality rate over time.It is important to emphasize that there is considerable variability in the phenotypic presentation of UC.Within this context,certain clinical and demographic characteristics are useful in identifying patients who tend to have more severe evolution of the disease and a poor prognosis.In this group of patients,better clinical surveillance and more intensive therapy may change the natural course of the disease.The aim of this article was to review the epidemiology and demographic characteristics of UC and the factors that may be associated with its clinical prognosis. | Bruno César da Silva Andre Castro Lyra Raquel Rocha Genoile Oliveira Santana | 2014 | World Journal of Gastroenterology2014，20，28： | 48 |
| 2 | Feasibility and safety of autologous bone marrow mononuclear cell transplantation in patients with advanced chronic liver disease显示文摘AIM: To evaluate the safety and feasibility of bone marrow cell (BMC) transplantation in patients with chronic liver disease on the waiting list for liver transplantation. METHODS: Ten patients (eight males) with chronic liver disease were enrolled to receive infusion of autologous bone marrow-derived cells. Seven patients were classified as Child-Pugh B and three as Child-Pugh C. Baseline assessment included complete clinical and laboratory evaluation and abdominal MRI. Approximately 50 ml of bone marrow aspirate was prepared by centrifugation in a ficoll-hypaque gradient. At least of 100 millions of mononuclear-enriched BMCs were infused into the hepatic artery using the routine technique for arterial chemoembolization for liver tumors. Patients were followed up for adverse events up to 4 mo. RESULTS: The median age of the patients was 52 years (range 24-70 years). All patients were discharged 48 h after BMC infusion. Two patients complained ofmild pain at the bone marrow needle puncture site. No other complications or specific side effects related to the procedure were observed. Bilirubin levels were lower at 1 (2.19 ± 0.9) and 4 mo (2.10 ± 1.0) after cell transplantation that baseline levels (2.78 ± 1.2). Albumin levels 4 mo after BMC infusion (3.73 ± 0.5) were higher than baseline levels (3.47 ± 0.5). International normalized ratio (INR) decreased from 1.48 (SD = 0.23) to 1.43 (SD = 0.23) one month after cell transplantation. CONCLUSION: BMC infusion into hepatic artery of patients with advanced chronic liver disease is safe and feasible. In addition, a decrease in mean serum bilirubin and INR levels and an increase in albumin levels are observed. Our data warrant further studies in order to evaluate the effect of BMC transplantation in patients with advanced chronic liver disease. | Andre Castro lyra Milena Botelho Pereira Soares luiz Flavio Maia da Silva Marcos Fraga Fortes André Goyanna Pinheiro Silva Augusto César de Andrade Mota Sheilla A Oliveira Eduardo lorens Braga Wilson Andrade de Carvalho Bernd Genser Ricardo Ribeiro dos Santos luiz Guilherme Costa lyra | 2007 | World Journal of Gastroenterology2007，13，7： | 21 |
| 3 | Risk factors for osteoporosis in inflammatory bowel disease patients显示文摘Inflammatory bowel disease(IBD) patients exhibit higher risk for bone loss than the general population. The chronic inflammation causes a reduction in bone mineral density(BMD), which leads to osteopenia and osteoporosis. This article reviewed each risk factor for osteoporosis in IBD patients. Inflammation is one of the factors that contribute to osteoporosis in IBD patients, and the main system that is involved in bone loss is likely RANK/RANKL/osteoprotegerin. Smoking is a risk factor for bone loss and fractures, and many mechanisms have been proposed to explain this loss. Body composition also interferes in bone metabolism and increasing muscle mass may positively affect BMD. IBD patients frequently use corticosteroids, which stimulates osteoclastogenesis. IBD patients are also associated with vitamin D deficiency, which contributes to bone loss. However, infliximab therapy is associated with improvements in bone metabolism, but it is not clear whether the effects are because of inflammation improvement or infliximab use. Ulcerative colitis patients with proctocolectomy and ileal pouches and Crohn's disease patients with ostomy are also at risk for bone loss, and these patients should be closely monitored. | Carla Andrade Lima Andre Castro Lyra Raquel Rocha Genoile Oliveira Santana | 2015 | World Journal of Gastrointestinal Pathophysiology2015，6，4： | 15 |
| 4 | Thalidomide induces mucosal healing in Crohn's disease: Case report显示文摘Crohn's disease is a chronic inflammatory disorder of the gastrointestinal tract that is defi ned by relapsing and remitting episodes. Tumor necrosis factor alpha (TNF-α) appears to play a central role in the pathophysiology of the disease. Standard therapies for inflammatory bowel disease fail to induce remission in about 30% of patients. Biological therapies have been associated with an increased incidence of infections, especially infection by Mycobacterium tuberculosis (Mtb). Thalidomide is an oral immunomodulatory agent with anti-TNF-α properties. Recent studies have suggested that thalidomide is effective in refractory luminal and fistulizing Crohn's disease. Thalidomide costimulates T lymphocytes, with greater effect on CD8+ than on CD4+ T cells, which contributes to the protective immune response to Mtb infection. We present a case of Crohn's disease with gastric, ileal, colon and rectum involvement as well as steroid dependency, which progressed with loss of response to infliximabafter three years of therapy. The thorax computed tomography scan demonstrated a pulmonary nodule suspected to be Mtb infection. The patient was started on thalidomide therapy and exhibited an excellent response. | Márcio Rios Leite Sandra Sousa Santos André Castro Lyra Jaciane Mota Genoile Oliveira Santana | 2011 | World Journal of Gastroenterology2011，17，45： | 9 |
| 5 | Predictive factors associated with hepatitis C antiviral therapy response显示文摘Hepatitis C virus(HCV) infection may lead to significant liver injury, and viral, environmental, host, immunologic and genetic factors may contribute to the differences in the disease expression and treatment response. In the early 2000 s, dual therapy using a combinationof pegylated interferon plus ribavirin(PR) became the standard of care for HCV treatment. In this PR era, predictive factors of therapy response related to virus and host have been identified. In 2010/2011, therapeutic regimens for HCV genotype 1 patients were modified, and the addition of NS3/4a protease inhibitors(boceprevir or telaprevir) to dual therapy increased the effectiveness and chances of sustained virologic response(SVR). Nevertheless, the first-generation triple therapy is associated with many adverse events, some of which are serious and associated with death, particularly in cirrhotic patients. This led to the need to identify viral and host predictive factors that might influence the SVR rate to triple therapy and avoid unnecessary exposure to these drugs. Over the past four years, hepatitis C treatment has been rapidly changing with the development of new therapies and other developments. Currently, with the more recent generations of pangenotipic antiviral therapies, there have been higher sustained virologic rates, and prognostic factors may not have the same importance and strength as before. Nonetheless, some variables may still be consistent with the low rates of non-response with regimens that include sofosbuvir, daclatasvir and ledipasvir. In this manuscript, we review the predictive factors of therapy response across the different treatment regimens over the last decade including the new antiviral drugs. | Lourianne Nascimento Cavalcante André Castro Lyra | 2015 | World Journal of Hepatology2015，7，12： | 4 |
| 6 | Infusion of autologous bone marrow mononuclear cells through hepatic artery results in a short-term improvement of liver function in patients with chronic liver disease: a pilot randomized controlled study显示文摘 | Andre Castro Lyra Milena Botelho Pereira Soares Luiz Flavio Maia da Silva Eduardo Lorens Braga Sheilla A. Oliveira Marcos Fraga Fortes Andre Goyanna Pinheiro Silva Daniele Brustolim Bernd Genser Ricardo Ribeiro dos Santos Luiz Guilherme Costa Lyra | 2010 | European Journal of Gastroenterology & Hepatology2010，，1： | 2 |
| 7 | Genetic ancestry analysis in non-alcoholic fatty liver disease patients from Brazil and Portugal显示文摘AIM:To study the association between genetic ancestry,non-alcoholic fatty liver disease(NAFLD) metabolic characteristics in two cohorts of patients,from Brazil and Portugal. METHODS:We included 131 subjects from Brazil [(n = 45 with simple steatosis(S. Steatosis) and n = 86 with nonalcoholic steatohepatitis(NASH)] and 90 patients from Portugal(n = 66,S. Steatosis; n = 24,NASH). All patients had biopsy-proven NAFLD. In histologic evaluation NAFLD activity score was used to assess histology and more than 5 points defined NASH in this study. Patients were divided into two groups according to histology diagnosis:simple steatosis or non-alcoholic statohepatitis. Genetic ancestry was assessed using real-time polymerase chain reaction. Seven ancestry informative markers(AT3-I/D,LPL,Sb19.3,APO,FYNull,PV92,and CKMM) with the greatest ethnicgeographical differential frequencies(≥ 48%) were used to define genetic ancestry. Data were analyzed using R PROJECTS software. Ancestry allele frequencies between groups were analyzed by GENEPOP onlineand the estimation of genetic ancestry contribution was evaluated by ADMIX-95 software. The 5% alpha-error was considered as significant(P < 0.05). RESULTS:In the Brazilian sample,NASH was significantly more frequent among the elderly patients with diabetes(NASH 56 ± 1.1 years old vs S. Steatosis 51 ± 1.5 years old,P = 3.7 x 10-9),dyslipidemia(NASH 63% vs S. Steatosis 37%,P = 0.009),higher fasting glucose levels(NASH 124 ± 5.2 vs S. Steatosis 106 ± 5.3,P = 0.001) and Homeostatic Model of Assessment index > 2.5 [NASH 5.3(70.8%) vs S. Steatosis 4.6(29.2%) P = 0.04]. In the Portuguese study population,dyslipidemia was present in all patients with NASH(P = 0.03) and hypertension was present in a larger percentage of subjects in the S. Steatosis group(P = 0.003,respectively). The genetic ancestry contribution among Brazilian and Portuguese individuals with NASH was similar to those with S. Steatosis from each cohort(Brazilian cohort:P = 0.75; Portuguese cohort:P = 0.97). Nonetheless,the genetic ancestry contribution of the Brazilian and Portuguese population were different,and a greater European and Amerindian ancestry contribution was detected in the Portuguese population while a higher African genetic ancestry contribution was observed in Brazilian population of both NASH and S. Steatosis groups.CONCLUSION:There was no difference between the genetic ancestry contribution among Brazilian and Portuguese individuals with NASH and S. Steatosis from each cohort. | Lourianne Nascimento Cavalcante Jose Tadeu Stefano Mariana V Machado Daniel F Mazo Fabiola Rabelo Kiyoko Abe Sandes Flair Jose Carrilho Helena Cortez-Pinto Andre Castro Lyra Claudia P de Oliveira | 2015 | World Journal of Hepatology2015，7，10： | 2 |
| 8 | Epidemiological profile of alcoholic liver disease hospital admissions in a Latin American country over a 10-year period显示文摘BACKGROUND Alcoholic liver disease(ALD)is a major cause of chronic liver disease worldwide.AIM To describe the epidemiological profile and mortality rates of patients with ALD admitted to public hospitals in different regions of Brazil from 2006 to 2015.METHODS This is a descriptive study that evaluated aggregate data from the five Brazilian geographic regions.RESULTS A total of 160093 public hospitalizations for ALD were registered.There was a 34.07%increase in the total number of admissions over 10 years,from 12879 in 2006 to 17267 in 2015.The region with the highest proportion(49.01%)of ALD hospitalizations was Southeast(n=78463).The North region had the lowest absolute number of patients throughout the study period,corresponding to 3.9%of the total(n=6242).There was a 24.72%increase in the total number of ALD deaths between 2006 and 2015.We found that the age group between 50 and 59 years had the highest proportion of both hospitalizations and deaths:28.94%(n=46329)of total hospital admissions and 29.43%(n=28864)of all deaths.Men were more frequently hospitalized than women and had the highest proportions of deaths in all regions.Mortality coefficient rates increased over the years,and simple linear regression analysis indicated a statistically significant upward trend in this mortality(R^2=0.744).CONCLUSION Our study provides a landscape of the epidemiological profile of public hospital admissions due to ALD in Brazil.We detected an increase in the total number of admissions and deaths due to ALD over 10 years. | Andre Castro Lyra Lorena Mascarenhas Carneiro de Almeida Yukari Figueroa Mise Lourianne Nascimento Cavalcante | 2020 | World Journal of Hepatology2020，12，5： | 1 |
| 9 | Sweet syndrome as a paraneoplastic manifestation of cholangiocarcinoma:A case report显示文摘BACKGROUND Sweet’s syndrome,also known as acute febrile neutrophilic dermatosis,is a rare skin disorder that may be associated with cancer.CASE SUMMARY A 58-year-old female presented with a cholestatic syndrome and significant weight loss three months before admission.Five months earlier,she had abruptly developed skin lesions with erythematous papules that evolved to erythematous blisters.Clinical evaluation and laboratory tests confirmed hepatic cholangiocarcinoma.Skin lesions histopathological findings showed neutrophilic dermatosis,massive edema,fibrin,necrosis,and elastosis.These results,in association with the macroscopic aspects of the findings,led to the diagnosis of paraneoplastic Sweet’s syndrome due to cholangiocarcinoma.As staging was consistent with an advanced tumor without a cure perspective,we opted to perform percutaneous biliary drainage,and subsequently,palliative care.Eventually,after a few weeks,the patient died.CONCLUSION In conclusion,the diagnosis of the underlying disease-causing Sweet’s syndrome must be accurate,and patients need to be followed-up,as neoplasia such as cholangiocarcinoma may be a later manifestation. | Camille Carneiro Lemaire Ana Luisa Carvalho Portilho Luciana V Pinheiro Rafael Alves Vivas Maíra Britto Melaine Montenegro Luiz Felipe de Farias Rodrigues Sérgio Arruda AndréCastro Lyra Lourianne Nascimento Cavalcante | 2020 | World Journal of Clinical Cases2020，8，18： | 0 |
| 10 | Overweight and abdominal fat are associated with normal bone mineral density in patients with ulcerative colitis显示文摘BACKGROUND Low bone mineral density(BMD)is common in patients with inflammatory bowel disease.However,nutritional risk factors for low BMD in the ulcerative colitis(UC)population are still poorly understood.AIM To investigate the association of anthropometric indicators and body composition with BMD in patients with UC.METHODS This is a cross-sectional study on adult UC patients of both genders who were followed on an outpatient basis.A control group consisting of healthy volunteers,family members,and close people was also included.The nutritional indicators evaluated were body mass index(BMI),total body mass(TBM),waist circumference(WC),body fat in kg(BFkg),body fat in percentage(BF%),trunk BF(TBF),and also lean mass.Body composition and BMD assessments were performed by dual-energy X-ray absorptiometry.RESULTS The sociodemographic characteristics of patients with UC(n=68)were similar to those of healthy volunteers(n=66)(P>0.05).Most patients(97.0%)were in remission of the disease,58.8%were eutrophic,33.8%were overweight,39.0%had high WC,and 67.6%had excess BF%.However,mean BMI,WC,BFkg,and TBF of UC patients were lower when compared to those of the control group(P<0.05).Reduced BMD was present in 41.2%of patients with UC(38.2%with osteopenia and 2.9%with osteoporosis)and 3.0%in the control group(P<0.001).UC patients with low BMD had lower BMI,TBM,and BFkg values than those with normal BMD(P<0.05).Male patients were more likely to have low BMD(prevalence ratio[PR]=1.86;95%confidence interval[CI]:1.07-3.26).Those with excess weight(PR=0.43;95%CI:0.19-0.97)and high WC(PR=0.44;95%CI:0.21-0.94)were less likely to have low BMD.CONCLUSION Patients with UC in remission have a high prevalence of metabolic bone diseases.Body fat appears to protect against the development of low BMD in these patients. | Mirella Brasil Lopes Andre Castro Lyra Raquel Rocha Fernanda Gomes Coqueiro Carla Andrade Lima Carolina Cunha de Oliveira Genoile Oliveira Santana | 2022 | World Journal of Gastrointestinal Pharmacology and Therapeutics2022，13，4： | 0 |
| 11 | Crohn's disease in one mixed-race population in Brazil显示文摘AIM: To evaluate the classification and severity of Crohn's disease in different racial groups.METHODS: Patients with Crohn's disease from the outpatient clinic of the University Hospital Prof. Edgard Santos were enrolled in the study. This hospital is a reference centre for inflammatory bowel disease. Race was determined using self-identification. The Vienna's classification was applied for all subjects. The severity of Crohn's disease was determined according to the number of surgical procedures, hospital admissions in the last year and treatment with steroids and immunosuppressors. Statistical analysis was calculated using t test for means, χ2 or F for proportions. A P value < 0.05 was considered to be significant.RESULTS: Sixty-five patients were enrolled. Non-white patients were more frequently diagnosed with Crohn's disease in the age less than 40 years than white patients. The behaviour of disease was similar in both groups with a high frequency of the penetrating form. There was a tendency for non-white patients to have a greater frequency of hospital admissions in the last year compared to white subjects. Non-whites also had a higher rate of colonic and upper gastrointestinal involvement, and were also more frequently on treatment with immunossupressors than white patients although this difference was not statistically significant.CONCLUSION: Non-white patients with Crohn's diseasehad an earlier diagnosis and appeared to have had a more severe disease presentation than white patients. | Genoile Oliveira Santana Luiz Guilherme Costa Lyra Tamara Celi Almeida Santana Lidiane Bianca dos Reis Jorge Carvalho Guedes Maria Betania Toralles André Castro Lyra | 2007 | World Journal of Gastroenterology2007，13，33： | 0 |
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