Publications by authors named "Emanuel Dias"

Background: Small bowel capsule endoscopy (SBCE) is an essential tool for evaluation of small bowel (SB) Crohn disease (CD). Fecal calprotectin (FC) represents an important biomarker of intestinal inflammation, widely used in ulcerative colitis and CD. Our aim was to evaluate the role of FC for diagnosing inflammatory activity in patients with isolated SB CD and how it correlates with SBCE findings.

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Article Synopsis
  • The Baveno VII guidelines aim to help determine which patients with chronic liver disease can skip esophagogastroduodenoscopy (EGD) screening for varices.
  • A study compared the prevalence of gastric neoplasia in 481 patients with compensated advanced chronic liver disease (cACLD) to 1,364 healthy individuals who underwent EGD.
  • Results showed a significantly higher rate of gastric neoplasia in cACLD patients (4.0% versus 1.0% in healthy individuals), suggesting that EGD remains important for cACLD patients, especially in areas with a higher risk of gastric cancer.
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We present the first assessment of the diet of the blackchin guitarfish Glaucostegus cemiculus (Geoffroy Saint-Hilaire, 1817) for West Africa using DNA metabarcoding on stomach contents of individuals captured in the Bijagós Archipelago, Guinea-Bissau. The diet was dominated by crustaceans, particularly caramote prawn Penaeus kerathurus (frequency of occurrence [FO] = 74%, numerical frequency [NF] = 54%) and fiddler crab Afruca tangeri (FO = 74%, NF = 12%). Bony fishes were present in 30% of the stomachs.

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Article Synopsis
  • *Doppler ultrasonography is essential for diagnosing IPA and differentiating it from other conditions.
  • *Treatment options vary widely, including conservative approaches and surgery, and monitoring after the procedure is crucial to prevent severe complications like hand ischemia.
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The identification of antifungal compounds produced by microorganisms is crucial in the context of sustainable agriculture. Bacteria of the genus Bacillus have a broad spectrum of action that can influence plant growth and control pests, vectors of public health relevance and phytopathogens. Lipopeptides are the main compounds related to the biological control of several pathogen species.

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Paradoxical embolism is a rare cause of arterial embolism, even more those resulting in acute ischemia of the upper limb. A case of a 45-year-old patient with acute paradoxical upper limb embolization and acute limb ischemia is presented. A review of the most recent evidence on the diagnosis and management of paradoxical embolism were explored.

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Dunbar syndrome or median arcuate ligament syndrome is a rare pathology that has a great impact on the quality of life of patients. This brief report aims to present a case report of a successful treatment of Dunbar syndrome and to review the current management of this entity. We present the case of a 37 year-old patient, who was treated by median arcuate ligament laparoscopic resection.

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Background: There is little information on diagnosis and management of small bowel lymphomas, and optimal management strategies are still undefined. This study aims to describe their main clinical and pathological characteristics and identify poor prognostic factors.

Methods: A retrospective observational study of all patients with histological diagnosis of small bowel lymphoma between January 2010 and December 2020 was performed.

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Background: The incidence of hepatic lymphoma has been increasing recently and diagnosis can be challenging as clinical presentation and radiological findings are usually variable and non-specific.

Objective: The aims of this study were to describe their main clinical, pathological and imaging characteristics and identify poor prognostic factors.

Methods: A retrospective study that included all patients with histological diagnosis of liver lymphoma over a 10-year period at our center was performed.

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Introduction: Small bowel adenocarcinoma is a rare but well-known complication of Crohn's disease. Diagnosis can be challenging, as clinical presentation may mimic an exacerbation of Crohn's disease and imaging findings may be indistinguishable from benign strictures. The result is that the majority of cases are diagnosed at the time of operation or postoperatively at an advanced stage.

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A 17-year-old male with no previous medical history presented with a 1-year history of rectal bleeding, mucus discharge and occasional rectal prolapse. Colonoscopy revealed several polypoidal growth masses in the distal rectum, formed by multiple sessile polyps with a glistening mucus-covered surface and fleshy, friable appearance, that coalesced forming large conglomerates. Given their complexity and large size, piecemeal endoscopic mucosal resection of the rectal lesions was performed and histopathological examination revealed ulcerated polypoid mucosa with mixed inflammatory cell infiltrate in the lamina propria and dilated cystic mucus-filled glands.

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A 51-year-old male with previous medical history of dyslipidemia performed screening colonoscopy, which revealed a sessile polypoid lesion with a diameter of approximately 8 mm located at the proximal transverse colon, which was resected en bloc with a cold snare. Remarkably, histopathological examination revealed a proliferation of spindle cells in the lamina propria entrapping colonic crypts without evidence of nuclear pleomorphism, mitotic figures or necrosis. On immunohistochemistry, spindle cells were diffusely positive for glucose transporter-1 and negative for S100, DOG1, CD34 and smooth muscle actin.

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A 40-year-old male with no previous medical history presented to emergency department with a 2-week history of progressive dyspnea. He also described night sweats and weight loss (15 kg) during the last 3 months. Thoraco-abdominal computed tomography showed multiple bilateral lung nodules associated with supra-clavicular, hilar and peri-esophageal lymphadenopathies and gastric parietal thickening.

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Background: Inflammatory bowel disease (IBD) may be associated with a wide range of hepatobiliary manifestations. This study aimed to characterize the spectrum of hepatobiliary disorders in patients with IBD who underwent liver biopsy for sustained abnormal liver function tests (LFT).

Method: A retrospective study was performed of all patients with IBD who underwent liver biopsy between January 2010 and December 2020 for sustained abnormal LFT (at least 6-month duration).

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The role of preoperative upper digestive endoscopy has been discussed with controversy in bariatric surgery. This study aims to evaluate the prevalence of endoscopic findings in obese patients undergoing bariatric surgery and their clinical impact. A retrospective observational study of all patients who performed upper endoscopy before bariatric surgery between January 2019 and December 2021 was performed.

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Gastrointestinal involvement occurs in approximately 4% of cases of systemic amyloidosis and may be associated with heterogeneous and nonspecific clinical manifestations and endoscopic findings, which poses important diagnostic challenges. A 76-year-old female with previous medical history of breast cancer, hypertension, dyslipidemia, asthma, and depression presented to emergency department with a 1-month history of diarrhea, abdominal pain, anorexia, asthenia, and weight loss. Physical examination revealed dehydration and abdominal tenderness.

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Colonoscopy is currently the gold-standard for the detection of colorectal lesions, but its accuracy in tumor localization is limited. This study aims to determine the accuracy of colonoscopy in localization of colorectal malignancy, identify possible influencing factors and evaluate the surgical consequences of an incorrect preoperative localization. A retrospective cross-sectional study of all patients with colorectal malignant lesions diagnosed by colonoscopy who underwent subsequent resection surgery between January 2019 and December 2020 was performed.

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Article Synopsis
  • A study examined whether a positive horizontal resection margin after endoscopic submucosal dissection (ESD) is linked to local recurrence of colorectal lesions.* -
  • The research included 354 patients with various lesions and found that, for noninvasive lesions, having a positive margin resulted in a slightly higher, but not significant, recurrence rate compared to clear margins.* -
  • However, for T1 lesions, the data indicated a notable increase in recurrence rates with positive margins, emphasizing the need for careful evaluation in these cases.*
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Recent developments in endoscopic techniques have contributed to establishing endoscopy as an essential tool in the management of different types of esophageal and gastric lesions. However, management of these lesions with underlying varices is challenging, considering the technical difficulties and increased risk of bleeding it entails with current endoscopic techniques. Consequently, most endoscopists are hesitant to use this technically challenging procedure.

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A 60-year-old female was diagnosed with acute myeloid leukemia. After initial remission with chemotherapy, she relapsed and underwent allogeneic hematopoietic stem cell transplantation (HSCT). Two months later, she presented to emergency department with watery diarrhea, abdominal pain and fever.

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A 77-year-old female with previous medical history of non-cirrhotic chronic hepatitis B and hepatocellular carcinoma treated with sequential partial hepatectomy followed by transarterial chemoembolization complained of pruritus and jaundice. Magnetic resonance cholangiopancreatography revealed a peri-hilar ill-defined stenosing lesion suggestive of malignancy. Endoscopic retrograde cholangiopancreatography with cholangioscopy confirmed a circumferential peri-hilar stenosis with fragile mucosa and tortuous dilated vessels and biopsies of this area were consistent cholangiocarcinoma.

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