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| 1 | Endoscopic papillary large balloon dilation after limited sphincterotomy for difficult biliary stones显示文摘AIM:To assess the efficacy and safety of endoscopic papillary large balloon dilation after biliary sphincterotomy for difficult bile duct stones retrieval.METHODS:Retrospective review of consecutive patients submitted to the technique during 18 mo.The main outcomes considered were:efficacy of the procedure(complete stone clearance;number of sessions;need of lithotripsy) and complications.RESULTS:A total of 30 patients with a mean age of 68 ± 10 years,23 female(77%) and 7 male(23%) were enrolled.In 10 patients,a single stone was found in the common bile duct(33%) and in 20 patients multiple stones(67%) were found.The median diameter of the stones was 17 mm(12-30 mm).Dilations were performed with progressive diameter Through-TheScope balloons(up to 12,15) or 18 mm.Complete retrieval of stones was achieved in a single session in 25 patients(84%) and in two sessions in 4 patients(13%).Failure occurred in 1 case(6%).Mechanical lithotripsywas performed in 6 cases(20%).No severe complications occurred.One patient(3%) had mild-grade post-endoscopic retrograde cholangiopancreatography(ERCP) pancreatitis.CONCLUSION:Endoscopic balloon dilatation with a large balloon after endoscopic sphincterotomy is a safe and effective technique that could be considered an alternative choice in therapeutic ERCP. | Ana Rebelo Pedro Moutinho Ribeiro António Pinto Correia José Cotter | 2012 | World Journal of Gastrointestinal Endoscopy2012，4，5： | 22 |
| 2 | Oral purgative and simethicone before small bowel capsule endoscopy显示文摘AIM:To evaluate small bowel cleansing quality,diagnostic yield and transit time,comparing three cleansing protocols prior to capsule endoscopy.METHODS:Sixty patients were prospectively enrolled and randomized to one of the following cleansing protocols:patients in Group A underwent a 24 h liquid diet and overnight fasting;patients in Group B followed protocol A and subsequently were administered 2 L of polyethylene glycol(PEG) the evening before the procedure;patients in Group C followed protocol B and were additionally administered 100 mg of simethicone 30 min prior to capsule ingestion.Small bowel cleansing was independently assessed by two experienced endoscopists and classified as poor,fair,good or excellent according to the proportion of small bowel mucosa under perfect conditions for visualization.When there was no agreement between the two endoscopists,the images were reviewed and discussed until a consensus was reached.The preparation was considered acceptable if > 50% or adequate if > 75% of the mucosa was in perfect cleansing condition.The amount of bubbles was assessed independently and it was considered significant if it prevented a correct interpretation of the images.Positive endoscopic findings,gastric emptying time(GET) and small bowel transit time(SBTT) were recorded for each examination.RESULTS:There was a trend favoring Group B in achieving an acceptable(including fair,good or excellent) level of cleansing(Group A:65%;Group B:83.3%;Group C:68.4%) [P = not significant(NS)] and favoring Group C in attaining an excellent level of cleansing(Group A:10%;Group B:16.7%;Group C:21.1%)(P = NS).The number of patients with an adequate cleansing of the small bowel,corresponding to an excellent or good classification,was 5(25%) in Group A,5(27.8%) in Group B and 4(21.1%) in Group C(P = 0.892).Conversely,7 patients(35%) in Group A,3 patients(16.7%) in Group B and 6 patients(31.6%) in Group C were considered to have poor small bowel cleansing(P = 0.417),with significant fluid or debris such that the examination was unreliable.The proportion of patients with a significant amount of bubbles was 50% in Group A,27.8% in Group B and 15.8% in Group C(P = 0.065).This was significantly lower in Group C when compared to Group A(P = 0.026).The mean GET was 27.8 min for Group A,27.2 min for Group B and 40.7 min for Group C(P = 0.381).The mean SBTT was 256.4 min for Group A,256.1 min for Group B and 258.1 min for Group C(P = 0.998).Regarding to the rate of complete examinations,the capsule reached the cecum in 20 patients(100%) in Group A,16 patients(88.9%) in Group B and 17 patients(89.5%) in Group C(P = 0.312).A definite diagnosis based on relevant small bowel endoscopic lesions was established in 60% of the patients in Group A(12 patients),44.4% in Group B(8 patients) and 57.8% in Group C(11 patients)(P = 0.587).CONCLUSION:Preparation with 2 L of PEG before small bowel capsule endoscopy(SBCE) may improve small bowel cleansing and the quality of visualization.Simethicone may further reduce intraluminal bubbles.No significant differences were found regarding GET,SBTT and the proportion of complete exploration or diagnostic yield among the three different cleansing protocols. | Bruno Joel Ferreira Rosa Mara Barbosa Joana Magalhes Ana Rebelo Maria Joo Moreira José Cotter | 2013 | World Journal of Gastrointestinal Endoscopy2013，5，2： | 21 |
| 3 | 在为困难的 choledocholithiasis 的 sphincterotomy 以后的内视镜的乳突的汽球膨胀: 控制盒子的研究显示文摘 AIM:To evaluate the efficacy and safety of endoscopic sphincterotomy(EST) + endoscopic papillary large balloon dilation(EPLBD)vs isolated EST.METHODS:We conducted a retrospective single center study over two years,from February 2010 to January 2012.Patients with large(≥ 10 mm),single or multiple bile duct stones(BDS),submitted to endoscopic retrograde cholangio-pancreatography(ERCP) were included.Patients in Group A underwent papillary large balloon dilation after limited sphincterotomy(EST+EPLBD),using a through-the-scope balloon catheter gradually inflated to 12-18 mm according to the size of the largest stone and the maximal diameter of the distal bile duct on the cholangiogram.Patients in Group B(control group) underwent isolated sphincterotomy.Stones were removed using a retrieval balloon catheter and/or a dormia basket.When necessary,mechanical lithotripsy was performed.Complete clearance of the bile duct was documented with a balloon catheter cholangiogram at the end of the procedure.In case of residual lithiasis,a double pigtail plastic stent was placed and a second ERCP was planned within 4-6 wk.Some patients were sent for extracorporeal lithotripsy prior to subsequent ERCP.Outcomes of EST+EPLBD(Group A) vs isolated EST(Group B) were compared regarding efficacy(complete stone clearance,number of therapeutic sessions,mechanical and/or extracorporeal lithotripsy,biliary stent placement) and safety(frequency,type and grade of complications).Statistical analysis was performed using χ 2 or Fisher’s exact tests for the analysis of categorical parameters and Student’s t test for continuous variables.A P-value of less than 0.05 was considered statistically significant.RESULTS:One hundred and eleven patients were included,68(61.3%) in Group A and 43(38.7%) in Group B.The mean diameter of the stones was similar in the two groups(16.8 ± 4.4 and 16.0 ± 6.7 in Groups A and B,respectively).Forty-eight(70.6%) patients in Group A and 21(48.8%) in Group B had multiple BDS(P = 0.005).Overall,balloon dilation was performed up to 12 mm in 10(14.7%) patients,13.5 mm in 17(25.0%),15 mm in 33(48.6%),16.5 mm in 2(2.9%) and 18 mm in 6(8.8%) patients,taking into account the diameter of the largest stone and that of the bile duct.Complete stone clearance was achieved in sixty-five(95.6%) patients in Group A vs 30(69.8%) patients in Group B,and was attained within the first therapeutic session in 82.4% of patients in Group A vs 44.2% in Group B(P < 0.001).Patients submitted to EST+EPLBD underwent fewer therapeutic sessions(1.1 ± 0.3 vs 1.8 ± 1.1,P < 0.001),and fewer required mechanical(14.7% vs 37.2%,P = 0.007) or extracorporeal(0 vs 18.6%,P < 0.001) lithotripsy,as well as biliary stenting(17.6% vs 60.5%,P < 0.001).The rate of complications was not significantly different between the two groups.CONCLUSION:EST+EPLBD is a safe and effective technique for treatment of difficult BDS,leading to high rates of complete stone clearance and reducing the need for lithotripsy and biliary stenting. | Bruno Rosa Pedro Moutinho Ribeiro Ana Rebelo António Pinto Correia José Cotter | 2013 | World Journal of Gastrointestinal Endoscopy2013，5，5： | 21 |
| 4 | Diagnosis and treatment of iron-deficiency anemia in gastrointestinal bleeding:A systematic review显示文摘BACKGROUND Anemia is considered a public health issue and is often caused by iron deficiency.Iron-deficiency anemia(IDA)often originates from blood loss from lesions in the gastrointestinal tract in men and postmenopausal women,and its prevalence among patients with gastrointestinal bleeding has been estimated to be 61%.However,few guidelines regarding the appropriate investigation of patients with IDA due to gastrointestinal bleeding have been published.AIM To review current evidence and guidelines concerning IDA management in gastrointestinal bleeding patients to develop recommendations for its diagnosis and therapy.METHODS Five gastroenterology experts formed the Digestive Bleeding and Anemia Workgroup and conducted a systematic literature search in PubMed and professional association websites.MEDLINE(via PubMed)searches combined medical subject headings(MeSH)terms and the keywords“gastrointestinal bleeding”with“iron-deficiency anemia”and“diagnosis”or“treatment”or“management”or“prognosis”or“prevalence”or“safety”or“iron”or“transfusion”or“quality of life”,or other terms to identify relevant articles reporting the management of IDA in patients over the age of 18 years with gastrointestinal bleeding;retrieved studies were published in English between January 2003 and April 2019.Worldwide professional association websites were searched for clinical practice guidelines.Reference lists from guidelines were reviewed to identify additional relevant articles.The recommendations were developed by consensus during two meetings and were supported by the published literature identified during the systematic search.RESULTS From 494 Literature citations found during the initial literature search,17 original articles,one meta-analysis,and 13 clinical practice guidelines were analyzed.Based on the published evidence and clinical experience,the workgroup developed the following ten recommendations for the management of IDA in patients with gastrointestinal bleeding:(1)Evaluation of hemoglobin and iron status;(2)Laboratory testing;(3)Target treatment population identification;(4)Indications for erythrocyte transfusion;(5)Treatment targets for erythrocyte transfusion;(6)Indications for intravenous iron;(7)Dosages;(8)Monitoring;(9)Indications for intravenous ferric carboxymaltose treatment;and(10)Treatment targets and monitoring of patients.The workgroup also proposed a summary algorithm for the diagnosis and treatment of IDA in patients with acute or chronic gastrointestinal bleeding,which should be implemented during the hospital stay and follow-up visits after patient discharge.CONCLUSION These recommendations may serve as a starting point for clinicians to better diagnose and treat IDA in patients with gastrointestinal bleeding,which ultimately may improve health outcomes in these patients. | Jose Cotter Cilenia Baldaia Manuela Ferreira Guilherme Macedo Isabel Pedroto | 2020 | World Journal of Gastroenterology2020，26，45： | 6 |
| 5 | Cirrhotic cardiomyopathy:Isn't stress evaluation alwaysrequired for the diagnosis?显示文摘AIM:To describe the proportion of patients with cirrhotic cardiomyopathy(CCM) evaluated by stress echocardiography and investigating its association with the severity of liver disease.METHODS:A cross-sectional study was conducted.Cirrhotic patients without risk factors for cardiovascular disease were included.Data regarding etiology and severity of liver disease(Child-Pugh score and model for end-stage liver disease),presence of ascites and gastroesophageal varices,pro-brain natriuretic peptide(proBNP) and corrected QT(QTc) interval were collected.Dobutamine stress echocardiography(conventional and tissue Doppler imaging) was performed.CCM was considered present when diastolic and/or systolic dysfunction was diagnosed at rest or after pharmacological stress.Therapy interfering with cardiovascular system was suspended 24 h before the examination.RESULTS:Twenty-six patients were analyzed,17(65.4%) Child-Pugh A,mean model for end-stage liver disease(MELD) score of 8.7.The global proportion of patients with CCM was 61.5%.At rest,only 2(7.7%)patients had diastolic dysfunction and none of the patients had systolic dysfunction.Dobutamine stress echocardiography revealed the presence of diastolic dysfunction in more 6(23.1%) patients and of systolic dysfunction in 10(38.5%) patients.QTc interval prolongation was observed in 68.8%of the patients and increased pro-BNP levels in 31.2%of them.There was no association between the presence of CCM and liver impairment assessed by Child-Pugh score or MELD(P= 0.775,P= 0.532,respectively).Patients with QTc interval prolongation had a significant higher rate of gastroesophageal varices comparing with those without QTc interval prolongation(95.0%vs 50.0%,P= 0.028).CONCLUSION:CCM is a frequent complication of cirrhosis that is independent of liver impairment.Stress evaluation should always be performed,otherwise it will remain an underdiagnosed condition. | mara barbosa joana guardado carla marinho bruno rosa isabel quelhas antónio lourenco josécotter | 2016 | World Journal of Hepatology2016，8，3： | 5 |
| 6 | Endoscopic retrograde cholangiopancreatography for suspected choledocholithiasis: From guidelines to clinical practice显示文摘AIM: To study the practical applicability of the American Society for Gastrointestinal Endoscopy guidelines in suspected cases of choledocholithiasis.METHODS: This was a retrospective single center study, covering a 4-year period, from January 2010 to December 2013. All patients who underwent endoscopic retrograde cholangiopancreatography(ERCP) for suspected choledocholithiasis were included. Based on the presence or absence of predictors of choledocholithiasis(clinical ascending cholangitis, common bile duct(CBD) stones on ultrasonography(US), total bilirubin > 4 mg/d L, dilated CBD on US, total bilirubin 1.8-4 mg/d L, abnormal liver function test, age > 55 years and gallstone pancreatitis), patients were stratified in low, intermediate or high risk for choledocholithiasis. For each predictor and risk group we used the χ2 to evaluate the statistical associations with the presence of choledocolithiasis at ERCP. Statistical analysis was performed using SPSS version 21.0. A P value of less than 0.05 was considered statistically significant. RESULTS: A total of 268 ERCPs were performed for suspected choledocholithiasis. Except for gallstone pancreatitis(P = 0.063), all other predictors of cho-ledocholitiasis(clinical ascending cholangitis, P = 0.001; CBD stones on US, P ≤ 0.001; total bilirubin > 4 mg/dL, P = 0.035; total bilirubin 1.8-4 mg/dL, P = 0.001; dilated CBD on US, P ≤ 0.001; abnormal liver function test, P = 0.012; age > 55 years, P = 0.002) showed a statistically significant association with the presence of choledocholithiasis at ERCP. Approximately four fifths of patients in the high risk group(79.8%, 154/193 patients) had confirmed choledocholithiasis on ERCP, vs 34.2%(25/73 patients) and 0(0/2 patients) in the intermediate and low risk groups, respectively. The definition of 'high risk group' had a sensitivity of 86%, positive predictive value 79.8% and specificity 56.2% for the presence of choledocholithiasis at ERCP. CONCLUSION: The guidelines should be considered to optimize patients' selection for ERCP. For high risk patients specificity is still low, meaning that some patients perform ERCP unnecessarily. | Joana Magalhes Bruno Rosa José Cotter | 2015 | World Journal of Gastrointestinal Endoscopy2015，7，2： | 5 |
| 7 | Upper gastrointestinal bleeding risk scores: Who, when andwhy?显示文摘Upper gastrointestinal bleeding(UGIB) remains a significant cause of hospital admission. In order to stratify patients according to the risk of the compli-cations, such as rebleeding or death, and to predict the need of clinical intervention, several risk scores have been proposed and their use consistently recommended by international guidelines. The use of risk scoring systems in early assessment of patients suffering from UGIB may be useful to distinguish high-risks patients, who may need clinical intervention and hospitalization, from low risk patients with a lower chance of developing complications, in which management as outpatients can be considered. Although several scores have been published and validated for predicting different outcomes, the most frequently cited ones are the Rockall score and the Glasgow Blatchford score(GBS). While Rockall score, which incorporates clinical and endoscopic variables, has been validated to predict mortality, the GBS, which is based on clinical and laboratorial parameters, has been studied to predict the need of clinical intervention. Despite the advantages previously reported, their use in clinical decisions is still limited. This review describes the different risk scores used in the UGIB setting, highlights the most important research, explains why and when their use may be helpful, reflects on the problems that remain unresolved and guides future research with practical impact. | Sara Monteiro Tiago Cúrdia Gonçalves Joana Magalhães JoséCotter | 2016 | World Journal of Gastrointestinal Pathophysiology2016，7，1： | 5 |
| 8 | “超级杂草”伴随着转基因作物而出现显示文摘最初的转基因大豆被基因工程业誉为'万金油'.它们能够在有除草剂的环境下生长,从理论上说,这将导致田地里那些不受欢迎的植物(比如杂草)的末日.这也将减少种植费用和除草剂的使用量.然而,多年来转基因技术的反对者们的预言现在已经变成了事实:随着时间的推移,'杂草'与转基因植物一样也具备了耐除草剂的特性.这便意味着必须应用其它除草剂,带来更多的花费. | Janet Cotter | 2004 | 世界环境2004，，5： | 4 |
| 9 | Risk of hepatitis B virus reactivation in patients with autoimmune diseases undergoing non-tumor necrosis factor-targeted biologics显示文摘Hepatitis B virus reactivation(HBVr)can occur in patients treated with immunosuppressive medications.Risk stratification for HBVr based on hepatitis B virus(HBV)serology and viral load is an important strategy to determine appropriate HBV monitoring and antiviral prophylaxis use.Recent advances in the understanding of pathophysiology of autoimmune diseases have led the development of cytokine-targeted therapies.Tumor necrosis factor(TNF)-αinhibitors have been widely used for patients with inflammatory bowel disease,psoriasis,and rheumatic diseases.Further,the clinical benefits of interleukin(IL)-12/23,IL-17,or Janus kinases inhibitors have been demonstrated in these patients.It is well known that TNF-αinhibitor use can lead to HBVr,however,the risk of HBVr in patients undergoing non-TNF-targeted biologics have not been fully understood.In this review,we discuss the risk of HBVr in patients treated with non-TNF-targeted biologics,and immunological mechanisms of these medications causing HBVr. | Shintaro Akiyama Thomas G Cotter Atsushi Sakuraba | 2021 | World Journal of Gastroenterology2021，27，19： | 4 |
| 10 | Finding the solution for incomplete small bowel capsule endoscopy显示文摘AIM:To evaluate whether the use of real time viewer(RTV)and administration of domperidone to patients with delayed gastric passage of the capsule could reduce the rate of incomplete examinations(IE)and improve the diagnostic yield of small bowel capsule endoscopy(SBCE).METHODS:Prospective single center interventional study,from June 2012 to February 2013.Capsule location was systematically checked one hour after ingestion using RTV.If it remained in the stomach,the patient received 10 mg domperidone per os and the location of the capsule was rechecked after 30 min.If the capsule remained in the stomach a second dose of10 mg of domperidone was administered orally.After another 30 min the position was rechecked and if the capsule remained in the stomach,it was passed into the duodenum by upper gastrointestinal(GI)endoscopy.The rate of IE and diagnostic yield of SBCE were compared with those of examinations performed before the use of RTV or domperidone in our Department(control group,January 2009-May 2012).RESULTS:Both groups were similar regarding age,sex,indication,inpatient status and surgical history.The control group included 307 patients,with 48(15.6%)IE.The RTV group included 82 patients,with3(3.7%)IE,P=0.003.In the control group,average gastric time was significantly longer in patients with IE than in patients with complete examination of the small bowel(77 min vs 26 min,P=0.003).In the RTV group,the capsule remained in the stomach one hour after ingestion in 14/82 patients(17.0%)vs 48/307(15.6%)in the control group,P=0.736.Domperidone did not significantly affect small bowel transit time(260min vs 297 min,P=0.229).The capsule detected positive findings in 39%of patients in the control group and 49%in the RTV group(P=0.081).CONCLUSION:The use of RTV and selective administration of domperidone to patients with delayed gastric passage of the capsule significantly reduces incomplete examinations,with no effect on small bowel transit time or diagnostic yield. | José Cotter Francisca Dias de Castro Joana Magalhes Maria Joo Moreira Bruno Rosa | 2013 | World Journal of Gastrointestinal Endoscopy2013，5，12： | 4 |
| 11 | Changes in the colon microbiota and intestinal cytokine gene expression following minimal intestinal surgery显示文摘AIM: To investigate the impact of minor abdominal surgery on the caecal microbial population and on markers of gut inflammation.METHODS: Four week old piglets were randomly allocated to a no-surgery 'control' group(n = 6) or a 'transection surgery' group(n = 5).During the transection surgery procedure, a conventional midline incision of the lower abdominal wall was made and the small intestine was transected at a site 225 cm proximal to the ileocaecal valve, a 2 cm segment was removed and the intestine was re-anastomosed.Piglets received a polymeric infant formula diet throughout the study period and were sacrificed at two weeks post-surgery.Clinical outcomes including weight, stool consistency and presence of stool fat globules were monitored.High throughput DNA sequencing of colonic content was used to detect surgery-relateddisturbances in microbial composition at phylum, family and genus level.Diversity and richness estimates were calculated for the control and minor surgery groups.As disturbances in the gut microbial community are linked to inflammation we compared the gene expression of key inflammatory cytokines(TNF, IL1 B, IL18, IL12, IL8, IL6 and IL10) in ileum, terminal ileum and colon mucosal extracts obtained from control and abdominal surgery groups at two weeks post-surgery.RESULTS: Changes in the relative abundance of bacterial species at family and genus level were confined to bacterial members of the Proteobacteria and Bacteroidetes phyla.Family level compositional shifts included a reduction in the relative abundance of Enterobacteriaceae(22.95 ± 5.27 vs 2.07 ± 0.72, P < 0.01), Bacteroidaceae(2.54 ± 0.56 vs 0.86 ± 0.43, P < 0.05) and Rhodospirillaceae(0.40 ± 0.14 vs 0.00 ± 0.00, P < 0.05) following transection surgery.Similarly, at the genus level, changes associated with transection surgery were restricted to members of the Proteobacteria and Bacteroidetes phyla and included decreased relative abundance of Enterobacteriaceae(29.20 ± 6.74 vs 2.88 ± 1.08, P < 0.01), Alistipes(4.82 ± 1.73 vs 0.18 ± 0.13, P < 0.05) and Thalassospira(0.53 ± 0.19 vs 0.00 ± 0.00, P < 0.05).Surgeryassociated microbial dysbiosis was accompanied by increased gene expression of markers of inflammation.Within the ileum IL6 expression was decreased(4.46 ± 1.60 vs 0.24 ± 0.06, P < 0.05) following transection surgery.In the terminal ileum, gene expression of TNF was decreased(1.51 ± 0.13 vs 0.80 ± 0.16, P < 0.01) and IL18(1.21 ± 0.18 vs 2.13 ± 0.24, P < 0.01), IL12(1.04 ± 0.16 vs 1.82 ± 0.32, P < 0.05) and IL10(1.04 ± 0.06 vs 1.43 ± 0.09, P < 0.01) gene expression increased following transection surgery.Within the colon, IL12(0.72 ± 0.13 vs 1.78 ± 0.28, P < 0.01) and IL10(0.98 ± 0.02 vs 1.95 ± 0.14, P < 0.01) gene expression were increased following transection surgery.CONCLUSION: This study suggests that minor abdominal surgery in infants, results in long-term alteration of the colonic microbial composition and persistent gastrointestinal inflammation. | Susan Lapthorne Julie E Bines Fiona Fouhy Nicole L Dellios Guineva Wilson Sarah L Thomas Michelle Scurr Catherine Stanton Paul D Cotter Prue M Pereira-Fantini | 2015 | World Journal of Gastroenterology2015，21，14： | 3 |
| 12 | Methods for improving thermal tolerance in military personnel prior to deployment显示文摘Acute exposure to heat, such as that experienced by people arriving into a hotter or more humid environment, can compromise physical and cognitive performance as well as health. In military contexts heat stress is exacerbated by the combination of protective clothing, carried loads, and unique activity profiles, making them susceptible to heat illnesses. As the operational environment is dynamic and unpredictable, strategies to minimize the effects of heat should be planned and conducted prior to deployment. This review explores how heat acclimation(HA) prior to deployment may attenuate the effects of heat by initiating physiological and behavioural adaptations to more efficiently and effectively protect thermal homeostasis, thereby improving performance and reducing heat illness risk. HA usually requires access to heat chamber facilities and takes weeks to conduct, which can often make it impractical and infeasible, especially if there are other training requirements and expectations. Recent research in athletic populations has produced protocols that are more feasible and accessible by reducing the time taken to induce adaptations, as well as exploring new methods such as passive HA. These protocols use shorter HA periods or minimise additional training requirements respectively, while still invoking key physiological adaptations, such as lowered core temperature, reduced heart rate and increased sweat rate at a given intensity. For deployments of special units at short notice(< 1 day) it might be optimal to use heat re-acclimation to maintain an elevated baseline of heat tolerance for long periods in anticipation of such an event. Methods practical for military groups are yet to be fully understood, therefore further investigation into the effectiveness of HA methods is required to establish the most effective and feasible approach to implement them within military groups. | Edward Tom Ashworth James David Cotter Andrew Edward Kilding | 2021 | Military Medical Research2021，8，3： | 3 |
| 13 | Essential role of small bowel capsule endoscopy in reclassification of colonic inflammatory bowel disease type unclassified显示文摘AIM To evaluate the role of small bowel capsule endoscopy(SBCE) on the reclassification of colonic inflammatory bowel disease type unclassified(IBDU).METHODS We performed a multicenter, retrospective study including patients with IBDU undergoing SBCE, between 2002 and 2014. SBCE studies were reviewed and the inflammatory activity was evaluated by determining the Lewis score(LS). Inflammatory activity was considered significant and consistent with Crohn's disease(CD) when the LS ≥ 135. The definitive diagnosis during follow-up(minimum 12 mo following SBCE) was based on the combination of clinical, analytical, imaging, endoscopic and histological elements.RESULTS Thirty-six patients were included, 21 females(58%) with mean age at diagnosis of 33 ± 13(15-64) years. The mean follow-up time after the SBCE was 52 ± 41(12-156) mo. The SBCE revealed findings consistent with significant inflammatory activity in the small bowel(LS ≥ 135) in 9 patients(25%); in all of them the diagnosis of CD was confirmed during follow-up. In 27 patients(75%), the SBCE revealed no significant inflammatory activity(LS < 135); among these patients, the diagnosis of Ulcerative Colitis(UC) was established in 16 cases(59.3%), CD in 1 case(3.7%) and 10 patients(37%) maintained a diagnosis of IBDU during follow-up. A LS ≥ 135 at SBCE had a sensitivity = 90%, specificity = 100%, positive predictive value = 100% and negative predictive value = 94% for the diagnosis of CD.CONCLUSION SBCE proved to be fundamental in the reclassification of patients with IBDU. Absence of significant inflammatory activity in the small intestine allowed exclusion of CD in 94% of cases. | Sara Monteiro Francisca Dias de Castro Pedro Boal Carvalho Bruno Rosa Maria Joao Moreira Rolando Pinho Miguel Mascarenhas Saraiva José Cotter | 2017 | World Journal of Gastrointestinal Endoscopy2017，9，1： | 3 |
| 14 | PillCam~ SB3 capsule: Does the increased frame rate eliminate the risk of missing lesions?显示文摘Since its emergence in 2000, small bowel capsule endoscopy(SBCE) has assumed a pivotal role as an investigation method for small bowel diseases. The PillCam SB2-ex offers 12 h of battery time, 4 more than the previous version(SB2). Rahman et al recently found that the PillCam SB2-ex has a significantly increased completion rate, although without higher diagnostic yield, compared with the SB2. We would like to discuss these somewhat surprising results and the new potentialities of the PillCam SB3 regarding the diagnostic yield of small bowel studies. PillCam SB3 offers improved image resolution and faster adaptable frame rate over previous versions of SBCE. We recently compared the major duodenal papilla detection rate obtained with PillCam SB3 and SB2 as a surrogate indicator of diagnostic yield in the proximal small bowel. The PillCam SB3 had a significantly higher major duodenal papilla detection rate than the PillCam SB2(42.7% vs 24%, P = 0.015). Thus, the most recent version of the PillCam capsule, SB3, may increase diagnostic yield, particularly in the proximal segments of the small bowel. | Sara Monteiro Francisca Dias de Castro Pedro Boal Carvalho Maria Joao Moreira Bruno Rosa José Cotter | 2016 | World Journal of Gastroenterology2016，22，10： | 2 |
| 15 | New Evidence on the Impact of Antithrombotics in Patients Submitted to Small Bowel Capsule Endoscopy for the Evaluation of Obscure Gastrointestinal Bleeding显示文摘 | Pedro Boal Carvalho Bruno Rosa Maria Jo?o Moreira José Cotter Gerassimos Mantzaris | 2014 | Gastroenterology Research and Practice2014，，： | 2 |
| 16 | Small bowel neuroendocrine tumors: From pathophysiologyto clinical approach显示文摘Neuroendocrine tumors(NETs), defined as epithelial tumors with predominant neuroendocrine differentiation, are among the most frequent types of small bowel neoplasm. They represent a rare, slow-growing neoplasm with some characteristics common to all forms and others attributable to the organ of origin. The diagnosis of this subgroup of neoplasia is not usually straight-forward for several reasons. Being a rare form of neoplasm they are frequently not readily considered in the differential diagnosis. Also, clinical manifestations are nonspecific lending the clinician no clue that points directly to this entity. However, the annual incidence of NETs has risen in the last years to 40 to 50 cases per million probably not due to a real increase in incidence but rather due to better diagnostic tools that have become progressively available. Being a rare malignancy, investigation regarding its pathophysiology and efforts toward better understanding and classification of these tumors has been limited until recently. Clinical societies dedicated to this matter are emerging(NANETS, ENETS and UKINETS) and several guidelines were published in an effort to standardize the nomenclature, grading and staging systems as well as diagnosis and management of NETs. Also, some investigation on the genetic behavior of small bowel NETs has been recently released, shedding some light on the pathophysiology of these tumors, and pointing some new directions on the possible treating options. In this review we focus on the current status of the overall knowledge about small bowel NETs, focusing on recent breakthroughs and its potential application on clinical practice. | Sofia Xavier Bruno Rosa JoséCotter | 2016 | World Journal of Gastrointestinal Pathophysiology2016，7，1： | 2 |
| 17 | Review of the disease course among adult ulcerative colitis population‐based longitudinal cohorts显示文摘 | FernandoMagro AndreiaRodrigues Ana IsabelVieira FranciscoPortela IsabelleCremers JoséCotter LuisCorreia Maria AntóniaDuarte Maria LourdesTavares PaulaLago PaulaMinistro PaulaPeixe SusanaLopes Elizabeth BenitoGarcia | 2012 | Inflamm Bowel Dis2012，，3： | 2 |
| 18 | 与久坐者相比,职业运动员的肠道菌群在代谢组分,尤其是功能代谢水平上有所不同显示文摘目的有证据表明肠道菌群以及影响其结构和活性的因素在人类代谢、免疫和发育过程中发挥作用。我们曾报道,与久坐者相比,诸如职业运动员,配有相应饮食的极度体育活动者肠道菌群种属和代谢组分发生了改变。这次我们重点研究这些因素对菌群功能/代谢活动的影响,以进一步揭示运动者和久坐者间的差别。方法对专业国际橄榄球联盟球员(样本数为40例)和对照(样本数为46例)的肠道菌群进行代谢表型和功能宏基因组分析,并将结果与生活方式指标(比如饮食习惯)和临床评估指标(比如血清肌酸激酶)进行关联。结果与对照相比,运动员组中与肌肉更新和整体健康相关的信号通路(比如:氨基酸、抗生素生物合成和碳水化合物代谢)和肠道菌群代谢产物(比如:短链脂肪酸乙酸酯、丙酸酯和丁酸酯)有所增加。结论运动和久坐相比,其肠道菌群在宏基因组和代谢组学上比组织水平显示出更大差异,拓展了饮食.运动.肠道微生态模式新视野。 | Barton W Penney NC Cronin O Garcia-Perez I Molloy MG Holmes E Shanahan F Cotter PD O'Sullivan O 毛玲娜 宋震亚 | 2017 | 英国医学杂志中文版2017，20，7： | 2 |
| 19 | Dose-dependent induction of apoptosis in human tumour cell lines by widely diverging stimuli 显示文摘 | LENNON S V MARTIN S J COTTER T G | 1991 | Cell Prolif1991，24，2： | 1 |
| 20 | Heat shock pioteins increase resistance to apoptosis显示文摘 | Cotter TG | 1996 | Exp Cell Res1996，223，1： | 1 |
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