Publications by authors named "Ligia Sassaki"

In this article, we explored the role of adipose tissue, especially mesenteric adipose tissue and creeping fat, and its association with the gut microbiota in the pathophysiology and progression of Crohn's disease (CD). CD is a form of inflammatory bowel disease characterized by chronic inflammation of the gastrointestinal tract, influenced by genetic predisposition, gut microbiota dysbiosis, and environmental factors. Gut microbiota plays a crucial role in modulating immune response and intestinal inflammation and is associated with the onset and progression of CD.

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  • * There are currently no specific diagnostic tests or drug treatments for CD, although research is exploring microRNAs (miRNAs) and their role in the disease's pathogenesis.
  • * The review highlights that miRNAs can influence various biological pathways tied to CD, suggesting that understanding these molecules may improve diagnosis, prognosis, and monitoring of the condition.
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Rationale: Ulcerative colitis (UC) is an inflammatory bowel disease (IBD) characterized by continuous inflammation of the colonic mucosa. Autoimmune hepatitis (AIH) is a chronic liver disease characterized by hypergammaglobulinemia, circulating autoantibodies, interface hepatitis, and favorable response to immunosuppression. An association between IBD and AIH is uncommon, and experts have suggested that in patients with overlapping IBD and AIH, the anti-tumor necrosis factor agents can be used.

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  • Managing IBD is becoming more complex due to new therapies, with the goal of achieving mucosal healing (MH) to prevent complications.
  • Monitoring fecal calprotectin levels and performing regular endoscopic evaluations are critical for assessing treatment effectiveness and detecting any underlying issues.
  • Future research needs to focus on stricter definitions of MH and improved analysis methods, including the use of new technologies and biomarkers.
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Background: Inflammatory bowel disease (IBD) affects young adults of reproductive age, and questions related to pregnancy and breastfeeding are common in clinical practice. Most medications used to treat IBD are considered safe during pregnancy, except methotrexate and small molecules such as tofacitinib. Despite few studies regarding vedolizumab (VDZ) safety, it appears to be safe during pregnancy.

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  • MicroRNAs (miRNAs) are small RNA molecules that regulate gene expression and impact over 30% of protein-coding genes, particularly in inflammatory processes and intestinal health.
  • Research indicates that dysregulated miRNA expression is closely linked to inflammatory bowel disease (IBD), specifically Crohn's disease and ulcerative colitis, highlighting their potential role as disease biomarkers.
  • Despite established regulatory functions of miRNAs in IBD, effective clinical biomarkers are still lacking, necessitating further research to leverage miRNAs for therapeutic approaches in personalized medicine.
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In this editorial, we comment on the article by Marangoni , published in the recent issue of the 2023; 29: 5618-5629, about "Diet as an epigenetic factor in inflammatory bowel disease". The authors emphasized the role of diet, especially the interaction with genetics, in promoting the inflammatory process in inflammatory bowel disease (IBD) patients, focusing on DNA methylation, histone modifications, and the influence of microRNAs. In this editorial, we explore the interaction between genetics, gut microbiota, and diet, in an only way.

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This study aims to develop and validate a nursing assessment tool for patients with inflammatory bowel disease. In this cross-sectional descriptive study using a quantitative approach, nurses were invited to participate. The Delphi technique was used to obtain a consensus among expert nurses.

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Unlabelled: The molecular processes linked to the development and progression of Crohn's disease (CD) and ulcerative colitis (UC) are not completely understood. MicroRNAs (miRNAs) regulate gene expression and are indicated as diagnostic, prognostic, and predictive biomarkers in chronic degenerative diseases. Our objectives included the identification of global miRNA expression in CD and UC, as well as miRNA target genes, miRNA-mRNA interaction networks, and biological functions associated with these different forms of inflammatory bowel disease (IBD).

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  • The Brazilian Organization for Crohn's Disease and Colitis (GEDIIB) created a national registry to study factors linked to the severity of inflammatory bowel disease (IBD) among Brazilian patients.
  • The study included 1,179 patients, primarily diagnosed with ulcerative colitis (UC) or Crohn's Disease (CD), and found that many had extensive disease, with a significant portion needing biologic treatments.
  • Factors like age, disease extent, and certain complications increased the severity of IBD, particularly for those with extensive colitis or specific disease behaviors.
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•An identification of the profile of inflammatory bowel disease nurses in Brazil was peformed, and only four nurses worked exclusively with patients with inflammatory bowel disease. •The main areas of activity were outpatient clinics and ostomy care. •Nursing care was based on the nursing process, and the main topics approached in these appointments were treatment adherence and ostomy.

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Tumor necrosis factor inhibitors (anti-TNFs) are widely used therapies for the treatment of inflammatory bowel diseases (IBD); however, their administration is not risk-free. Heart failure (HF), although rare, is a potential adverse event related to administration of these medications. However, the exact mechanism of development of HF remains obscure.

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Background: This is a secondary database study using the Brazilian public healthcare system database.

Aim: To describe intestinal complications (ICs) of patients in the Brazilian public healthcare system with Crohn's disease (CD) who initiated and either only received conventional therapy (CVT) or also initiated anti-tumor necrosis factor (anti-TNF) therapy between 2011 and 2020.

Methods: This study included patients with CD [international classification of diseases - 10 revision (ICD-10): K50.

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Article Synopsis
  • Inflammatory bowel disease (IBD), including Crohn's disease and ulcerative colitis, involves an overactive immune response in the gastrointestinal tract linked to gut microbiota and diet.
  • MicroRNAs (miRNAs) are important in regulating inflammation and could serve as diagnostic and prognostic markers for IBD.
  • Recent studies highlight the complex relationship between miRNAs and gut microbiota, suggesting that they influence each other's expression and impact intestinal health.
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Background: Inflammatory bowel diseases are immune-mediated disorders that include Crohn's disease (CD) and ulcerative colitis (UC). UC is a progressive disease that affects the colorectal mucosa causing debilitating symptoms leading to high morbidity and work disability. As a consequence of chronic colonic inflammation, UC is also associated with an increased risk of colorectal cancer.

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Background: Inflammatory bowel disease (IBD) is an immune-mediated disorder that includes Crohn's disease (CD) and ulcerative colitis. CD is characterized by a transmural intestinal involvement from the mouth to the anus with recurrent and remitting symptoms that can lead to progressive bowel damage and disability over time.

Objective: To guide the safest and effective medical treatments of adults with CD.

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Background: This was an observational, descriptive, and retrospective study from 2011 to 2020 from the Department of Informatics of the Brazilian Healthcare System database.

Aim: To describe the intestinal complications (IC) of patients with ulcerative colitis (UC) who started conventional therapies in Brazil´s public Healthcare system.

Methods: Patients ≥ 18 years of age who had at least one claim related to UC 10 revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10) code and at least 2 claims for conventional therapies were included.

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  • Higher serum concentrations of Adalimumab (ADA), an anti-TNF-α agent, may contribute to sustained treatment efficacy in Crohn's disease (CD), while low levels might lead to loss of response.
  • A multicentric study involving 89 CD patients on ADA for over 24 weeks found no significant differences in serum ADA levels between those with active disease and those in remission, either clinically or endoscopically.
  • Mean serum ADA concentrations were slightly lower in patients with active disease (10.2 μg/mL clinically; 11.3 μg/mL endoscopically) compared to those in remission (14.3 μg/mL clinically; 14.5 μg/mL end
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Background: Inflammatory bowel diseases (IBDs) are chronic diseases that demand continuous interaction between patients and healthcare providers. Quality of care (QoC) is a factor that contributes to a patient's adherence to treatment and its success.

Aim: To evaluate QoC in patients from a single IBD reference center.

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Polycystic liver disease (PLD) is a clinical condition characterized by the presence of more than 10 cysts in the liver. It is a rare disease Of genetic etiology that presents as an isolated disease or assoc\iated with polycystic kidney disease. Ductal plate malformation, ciliary dysfunction, and changes in cell signaling are the main factors involved in its pathogenesis.

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The gut microbiota is a complex community of microorganisms that inhabit the digestive tracts of humans, living in symbiosis with the host. Dysbiosis, characterized by an imbalance between the beneficial and opportunistic gut microbiota, is associated with several gastrointestinal disorders, such as irritable bowel syndrome (IBS); inflammatory bowel disease (IBD), represented by ulcerative colitis and Crohn's disease; and colorectal cancer (CRC). Dysbiosis can disrupt the mucosal barrier, resulting in perpetuation of inflammation and carcinogenesis.

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Background: The conventional treatment of inflammatory bowel disease (IBD) is based on drug therapy, but different studies have shown a progressive increase in the use of complementary and alternative medicine (CAM). The most used CAM comprises of acupuncture, traditional Chinese medicine, Ayurvedic medicine, homeopathy, and herbal medicine, as well as more modern practices, including aromatherapy and reflexology. Data from CAM use in Brazil has previously been scarce and there are no studies among Brazilian patients with IBD.

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  • Anti-TNF therapy has proven effective in treating ulcerative colitis (UC), but there's limited data on its impact on Brazilian patients; this study compares the efficacy of adalimumab (ADA) and infliximab (IFX) in achieving clinical and endoscopic remission after one year of treatment.
  • Conducted across 24 centers, the study included 393 UC patients and utilized various statistical methods to analyze treatment outcomes, finding that IFX showed better clinical remission rates compared to ADA at 26 and 52 weeks.
  • Results indicated a clinical remission rate of 82.82% at week 52, with IFX patients experiencing fewer instances of loss of response, although endoscopic remission rates did not significantly differ between the
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Autosomal dominant polycystic liver disease (ADPLD) is a rare disease with variable clinical presentations, characterized by cystic enlargement of the liver. The diagnosis is made based on family history, patient's age, and liver phenotype and is confirmed by imaging tests. The treatment aims to reduce symptoms caused by the increased liver volume and can be performed by aspiration with sclerotherapy, fenestration, and liver resection.

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  • Immune thrombocytopenic purpura (ITP) occurs due to autoantibodies attacking platelets, leading to their destruction and is a rare complication of ulcerative colitis (UC).
  • A case report details a 49-year-old man with UC who developed ITP and experienced severe thrombocytopenia despite treatment, leading to various medication adjustments.
  • Proper diagnosis and treatment of ITP in UC patients is crucial to prevent serious complications, like bleeding, and to enhance the patient's overall health outcomes.
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