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Falcão D, Ferreira D, Maia L, Sadio A, Pedroto I. Hemostatic spray as a therapy for pancreatic stump bleeding after cephalic duodenopancreatectomy. Rev Esp Enferm Dig 2023; 115:456-457. [PMID: 36263820 DOI: 10.17235/reed.2022.9249/2022] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/05/2023]
Abstract
A 70-year-old man with a cholangiocarcinoma underwent a cephalic duodenopancreatectomy. On the 2nd postoperative day, he had hematemesis without hemodynamic instability. Upper endoscopy (EGD) revealed a massive clot at the pancreatic stump, suspected as the source of hemorrhage. After partial clot removal, no active bleeding was found and no therapy was performed. Pancreaticogastric and gastrojejunal anastomoses, as well as the efferent-limb, showed no suspicious lesions. Octreotide was initiated and heparin prophylaxis was temporarily stopped. Bleeding from pancreatic stump following pancreatoduodenectomy is a rare but a life-threatening condition. Conventional endoscopic therapies, including clip placement and cautery, are mostly ineffective and with high risk of pancreatitis. We report the second case of hemostatic powder as a safe and successful therapy in this scenario.
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Affiliation(s)
- Daniela Falcão
- Gastrenterology, Centro Hospitalar Universitário do Porto, Portugal
| | | | - Luís Maia
- Gastroenterology, Centro Hospitalar Universitário do Porto
| | - Ana Sadio
- Gastroenterology, Centro Hospitalar Universitário do Porto
| | - Isabel Pedroto
- Gastroenterology, Centro Hospitalar Universitário do Porto, Portugal
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Sadio A, Fall I, Mbodji S, Sissoko GG. Analysis of Meteorological Data for applications in Ngoundiane’s Site. EAI Endorsed Transactions on Collaborative Computing 2017. [DOI: 10.4108/eai.9-10-2017.153168] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Sadio A, Amaral AL, Nunes R, Ricardo S, Sarmento B, Almeida R, Tsukamoto H, das Neves J. A Mouse Intra-Intestinal Infusion Model and its Application to the Study of Nanoparticle Distribution. Front Physiol 2016; 7:579. [PMID: 27965585 PMCID: PMC5126386 DOI: 10.3389/fphys.2016.00579] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Accepted: 11/11/2016] [Indexed: 12/16/2022] Open
Abstract
The oral route is the most preferable one when it comes to drug administration. Different animal models have been used to characterize the fate of potential medicines upon oral delivery but fail to clarify specific events occurring at localized sites of the gastrointestinal tract, particularly at the small intestine. We developed a new mouse intra-intestinal infusion model that enabled the direct administration of substances (such as drugs or nanoparticle drug carriers) in the small intestine through an implanted catheter, which can be maintained for prolonged periods of time. The location of catheter insertion can be previously determined as more proximal or distal, allowing to test specific portions of the intestine. Since the model is presumably able to maintain normal physiological characteristics, namely the mucus coating of the intestinal wall, it allowed studying the distribution of different nanoparticles upon localized intra-intestinal administration. The hereby proposed mouse model has the potential to be useful in other types of studies, namely in clarifying localized processes occurring at specific sites of the intestine.
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Affiliation(s)
- Ana Sadio
- Instituto de Investigação e Inovação em Saúde, Universidade do PortoPorto, Portugal; Institute of Molecular Pathology and Immunology of the University of PortoPorto, Portugal; Faculty of Medicine of the University of PortoPorto, Portugal; Gastroenterology Department, Unidade Local Saúde da GuardaGuarda, Portugal; Gulbenkian Programme for Advanced Medical EducationLisbon, Portugal
| | - Ana L Amaral
- Instituto de Investigação e Inovação em Saúde, Universidade do PortoPorto, Portugal; Institute of Molecular Pathology and Immunology of the University of PortoPorto, Portugal
| | - Rute Nunes
- Instituto de Investigação e Inovação em Saúde, Universidade do PortoPorto, Portugal; Instituto de Engenharia Biomédica, Universidade do PortoPorto, Portugal; Instituto de Ciências Biomédicas Abel Salazar, Universidade do PortoPorto, Portugal
| | - Sara Ricardo
- Instituto de Investigação e Inovação em Saúde, Universidade do PortoPorto, Portugal; Institute of Molecular Pathology and Immunology of the University of PortoPorto, Portugal
| | - Bruno Sarmento
- Instituto de Investigação e Inovação em Saúde, Universidade do PortoPorto, Portugal; Instituto de Engenharia Biomédica, Universidade do PortoPorto, Portugal; CESPU - Instituto de Investigação e Formação Avançada em Ciências e Tecnologias da Saúde, Instituto Universitário de Ciências da SaúdeGandra, Portugal
| | - Raquel Almeida
- Instituto de Investigação e Inovação em Saúde, Universidade do PortoPorto, Portugal; Institute of Molecular Pathology and Immunology of the University of PortoPorto, Portugal; Faculty of Medicine of the University of PortoPorto, Portugal; Biology Department, Faculty of Sciences of the University of PortoPorto, Portugal
| | - Hidekazu Tsukamoto
- Department of Pathology, Southern California Research Center for ALPD and Cirrhosis, Keck School of Medicine of the University of Southern CaliforniaLos Angeles, CA, USA; Department of Veterans Affairs Greater Los Angeles Healthcare SystemLos Angeles, CA, USA
| | - José das Neves
- Instituto de Investigação e Inovação em Saúde, Universidade do PortoPorto, Portugal; Instituto de Engenharia Biomédica, Universidade do PortoPorto, Portugal
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Sadio A, Gustafsson JK, Pereira B, Gomes CP, Hansson GC, David L, Pêgo AP, Almeida R. Modified-chitosan/siRNA nanoparticles downregulate cellular CDX2 expression and cross the gastric mucus barrier. PLoS One 2014; 9:e99449. [PMID: 24925340 PMCID: PMC4055692 DOI: 10.1371/journal.pone.0099449] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2014] [Accepted: 05/15/2014] [Indexed: 11/18/2022] Open
Abstract
Development of effective non-viral vectors is of crucial importance in the implementation of RNA interference in clinical routine. The localized delivery of siRNAs to the gastrointestinal mucosa is highly desired but faces specific problems such as the stability in gastric acidity conditions and the presence of the mucus barrier. CDX2 is a transcription factor critical for intestinal differentiation being involved in the initiation and maintenance of gastrointestinal diseases. Specifically, it is the trigger of gastric intestinal metaplasia which is a precursor lesion of gastric cancer. Its expression is also altered in colorectal cancer, where it may constitute a lineage-survival oncogene. Our main objective was to develop a nanoparticle-delivery system of siRNA targeting CDX2 using modified chitosan as a vector. CDX2 expression was assessed in gastric carcinoma cell lines and nanoparticles behaviour in gastrointestinal mucus was tested in mouse explants. We show that imidazole-modified chitosan and trimethylchitosan/siRNA nanoparticles are able to downregulate CDX2 expression and overpass the gastric mucus layer but not colonic mucus. This system might constitute a potential therapeutic approach to treat CDX2-dependent gastric lesions.
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Affiliation(s)
- Ana Sadio
- IPATIMUP- Instituto de Patologia e Imunologia Molecular da Universidade do Porto, Porto, Portugal
- INEB – Instituto de Engenharia Biomédica, Universidade do Porto, Porto, Portugal
- Gastroenterology Department, Unidade Local Saúde da Guarda, Guarda, Portugal
- Gulbenkian Programme for Advanced Medical Education, Lisboa, Portugal
- Faculdade de Medicina da Universidade do Porto, Porto, Portugal
| | - Jenny K. Gustafsson
- Department of Medical Biochemistry, University of Gothenburg, Gothenburg, Sweden
| | - Bruno Pereira
- IPATIMUP- Instituto de Patologia e Imunologia Molecular da Universidade do Porto, Porto, Portugal
| | - Carla Pereira Gomes
- INEB – Instituto de Engenharia Biomédica, Universidade do Porto, Porto, Portugal
- Faculdade de Engenharia da Universidade do Porto, Porto, Portugal
| | - Gunnar C. Hansson
- Department of Medical Biochemistry, University of Gothenburg, Gothenburg, Sweden
| | - Leonor David
- IPATIMUP- Instituto de Patologia e Imunologia Molecular da Universidade do Porto, Porto, Portugal
- Faculdade de Medicina da Universidade do Porto, Porto, Portugal
| | - Ana Paula Pêgo
- INEB – Instituto de Engenharia Biomédica, Universidade do Porto, Porto, Portugal
- Faculdade de Engenharia da Universidade do Porto, Porto, Portugal
- ICBAS - Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal
| | - Raquel Almeida
- IPATIMUP- Instituto de Patologia e Imunologia Molecular da Universidade do Porto, Porto, Portugal
- Faculdade de Medicina da Universidade do Porto, Porto, Portugal
- * E-mail:
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Sadio A, Peixoto P, Cancela E, Castanheira A, Marques V, Ministro P, Silva A, Caldas A. Intramural hematoma: a rare complication of endoscopic injection therapy for bleeding peptic ulcers. Endoscopy 2011; 43 Suppl 2 UCTN:E141-2. [PMID: 21425016 DOI: 10.1055/s-0029-1214927] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- A Sadio
- Department of Gastroenterology, São Teotónio Hospital, Viseu, Portugal.
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Sadio A, Peixoto P, Castanheira A, Cancela E, Ministro P, Silva A, Caldas A. Dieulafoy's lesion in a duodenal diverticulum successfully treated with N-butyl-2-cyanoacrylate. Rev Esp Enferm Dig 2010; 102:396-8. [PMID: 20575607 DOI: 10.4321/s1130-01082010000600015] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Sadio A, Peixoto P, Castanheira A, Cancela E, Ministro P, Casimiro C, Silva A. Gastric lipoma--an unusual cause of upper gastrointestinal bleeding. Rev Esp Enferm Dig 2010; 102:398-400. [PMID: 20575608 DOI: 10.4321/s1130-01082010000600016] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Cancela E, Ministro P, Peixoto P, Sadio A, Castanheira A, Silva A, Caldas A. Concomitant life threatening lesions in a cirrhotic patient: the value of endoscopic treatment. Rev Esp Enferm Dig 2010; 102:617-8. [PMID: 21039079 DOI: 10.4321/s1130-01082010001000016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Peixoto P, Sadio A, Cancela E, Castanheira A, Ministro P, Silva A, Caldas A. Acute upper bleeding due to an unusual complication of peptic ulcer disease--double pylorus. Rev Esp Enferm Dig 2010; 102:451-3. [PMID: 20617870 DOI: 10.4321/s1130-01082010000700012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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Peixoto P, Amaro P, Sadio A, Figueiredo P, Almeida N, Gouveia H, Coutinho L, Barros A, Silva MR, Leitão MC. A strange duodenal lesion. Rev Esp Enferm Dig 2010; 102:563-5. [PMID: 20883077 DOI: 10.4321/s1130-01082010000900012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Affiliation(s)
- Ana Sadio
- Gastroenterology Department, São Teotónio Hospital, Viseu, Portugal
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Peixoto P, Ministro P, Sadio A, Castanheira A, Cancela E, Araújo R, Silva A, Caldas A. Embolic complications associated with endoscopic injection of cyanoacrylate for bleeding duodenal ulcer. Endoscopy 2008; 40 Suppl 2:E126. [PMID: 18633868 DOI: 10.1055/s-2007-995695] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Affiliation(s)
- P Peixoto
- Gastroenterology Department, São Teotónio Hospital, Viseu, Portugal.
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Frachet C, Boughanem Z, Court M, Sadio A, Michaud M. [Therapeutic stubbornness: a form of acting out]. Soins Psychiatr 1994:10-3. [PMID: 7667690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
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Charbit Y, Ndiaye K, Ndiaye S, Sadio A, Sarr I. [Nuptiality and fertility in Senegal]. Ann IFORD 1989; 13:37-74. [PMID: 12178538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/26/2023]
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