Browsing by Author "Vigia, E"
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- Aquaporins Transcripts with Potential Prognostic Value in Pancreatic CancerPublication . Lopes, PA; Fonseca, E; da Silva, IV; Vigia, E; Paulino, J; Soveral, GPancreatic cancer is anticipated to be the second leading cause of cancer-related death by 2030. Aquaporins (AQPs), a family of water channel proteins, have been linked to carcinogenesis. The aim of this study was to determine AQP gene expression in pancreatic cancer tissues and to validate aquaporins as possible diagnosis and/or prognosis genes. The relative gene expression levels of AQP1, AQP3, AQP5, and AQP9 were analyzed using real-time quantitative PCR (RT-qPCR) in 24 paired pancreatic tumors and adjacent healthy tissues according to variables such as age, gender, and tumor invasiveness and aggressiveness. AQPs transcripts were detected in both healthy and tumor tissues. While AQP1 was downregulated in the tumor samples, AQP3 was particularly overexpressed in low-grade invasive tumors. Interestingly, most of the strong positive Pearson correlation coefficients found between AQPs in healthy tissues were lost when analyzing the tumor tissues, suggesting disruption of the coordinated AQP-gene expression in pancreatic cancer.
- Clinical Outcomes and Genetic Expression Profile in Human Liver Graft Dysfunction During Ischemia/Reperfusion InjuryPublication . Paulino, J; Vigia, E; Marcelino, P; Abade, O; Sobral, J; Ligeiro, D; Carvalho, A; Alves, M; Papoila, AL; Trindade, H; Barroso, EIntroduction. This study aims to compare the molecular gene expression during ischemia reperfusion injury. Several surgical times were considered: in the beginning of the harvesting (T0), at the end of the cold ischemia period (T1), and after reperfusion (T2) and compared with graft dysfunction after liver transplant (OLT). Methods. We studied 54 patients undergoing OLT. Clinical, laboratory data, and histologic data (Suzuki classification) as well as the Survival Outcomes Following Liver Transplantation (SOFT) score were used and compared with the molecular gene expression of the following genes: Interleukin (IL)-1b, IL-6, tumor necrosis factor-a, perforin, E-selectin (SELE), Fas-ligand, granzyme B, heme oxygenase-1, and nitric oxide synthetase. Results. Fifteen patients presented with graft dysfunction according to SOFT criteria. No relevant data were obtained by comparing the variables graft dysfunction and histologic variables. We observed a statistically significant relation between SELE at T0 (P ¼ .013) and IL-1b at T0 (P ¼ .028) and early graft dysfunction. Conclusions. We conclude that several genetically determined proinflammatory expressions may play a critical role in the development of graft dysfunction after OLT.
- Delayed Presentation of Isolated Grade III Pancreatic Injury - a Case ReportPublication . Ferreira, MJ; Gallardo, G; Vigia, E; Filipe, E; Pinto Marques, HBecause of their vague and subtle indications and symptoms, pancreatic injuries are frequently misdiagnosed. It's crucial to have a high level of clinical suspicion. The presence of other organ solid lesions and vascular injuries, as well as the patient's hemodynamic condition, will determine how these injuries are treated. A surgical approach is mandatory when a ductal disruption occurs. The case of a 32-year-old man who experienced an upper abdominal blunt trauma is presented. He was admitted to our hospital with an acute abdomen 48 hours later. A complete transection of the major pancreatic duct was discovered during surgical investigation, and a distal pancreatectomy with en bloc splenectomy was performed. Even in a delayed context, distal pancreatectomy can be safely performed and is the best option.
- Differential Expression of Aquaporin-3 and Aquaporin-5 in Pancreatic Ductal AdenocarcinomaPublication . Direito, I; Paulino, J; Vigia, E; Brito, MA; Soveral, GBackground and objectives: Aquaporin-5 (AQP5) and -3 (AQP3) are protein channels that showed to be up-regulated in a variety of tumors. Our goal was to investigate the expression pattern of AQP5 and AQP3 in pancreatic ductal adenocarcinomas (PDA) and correlate with cell proliferation, tumor stage and progression, and clinical significance. Methods: 35 PDA samples in different stages of differentiation and locations were analyzed by immunohistochemistry for expression of AQP5, AQP3 and several markers of cell proliferation and tumorigenesis. Results: In PDA samples AQP5 was overexpressed in the apical membrane of intercalated and intralobular ductal cells while AQP3 was expressed at the plasma membrane of ductal cells. AQP5 was also found in infiltrative cancer cells in duodenum. Simultaneous overexpression of EGFR, Ki-67, and CK7, with decreased E-cad and increased Vim that characterize epithelial mesenchymal transition, tumor formation and invasion, strongly suggest AQP3 and AQP5 involvement in cell proliferation and transformation. AQP3 overexpression is reinforced in late and more aggressive PDA stages whereas AQP5 is related with tumor differentiation, suggesting it may represent a novel marker for PDA aggressiveness and intestinal infiltration. Conclusions: These findings suggest AQP3 and AQP5 involvement in PDA development and the usefulness of AQP5 in early PDA diagnosis.
- Management of Asymptomatic Sporadic Non-Functioning Pancreatic Neuroendocrine Neoplasms No Larger Than 2 Cm: Interim Analysis of Prospective ASPEN TrialPublication . Partelli, S; Massironi, S; Zerbi, A; Niccoli, P; Kwon, W; Landoni, L; Panzuto, F; Tomazic, A; Bongiovanni, A; Kaltsas, G; Sauvanet, A; Bertani, E; Mazzaferro, V; Caplin, M; Armstrong, T; Weickert, M; Ramage, J; Segelov, E; Butturini, G; Staettner, S; Cives, M; Frilling, A; Moulton, C; He, J; Boesch, F; Selberheer, A; Twito, O; Castaldi, A; De Angelis, C; Gaujoux, S; Holzer, K; Wilson, C; Almeamar, H; Vigia, E; Muffatti, F; Lucà, M; Lania, A; Ewald, J; Kim, H; Salvia, R; Rinzivillo, M; Smid, A; Gardini, A; Tsoli, M; Hentic, O; Colombo, S; Citterio, D; Toumpanakis, C; Ramsey, E; Randeva, H; Srirajaskanthan, R; Croagh, D; Regi, P; Gasteiger, S; Invernizzi, P; Ridolfi, C; Giovannini, M; Jang, JY; Bassi, C; Falconi, M
- Management of Asymptomatic Sporadic Nonfunctioning Pancreatic Neuroendocrine Neoplasms (ASPEN) ≤2 cm: Study Protocol for a Prospective Observational StudyPublication . Partelli, S; Ramage, J; Massironi, S; Zerbi, A; Kim, H; Niccoli, P; Panzuto, F; Landoni, L; Tomazic, A; Ibrahim, T; Kaltsas, G; Bertani, E; Sauvanet, A; Segelov, E; Caplin, M; Coppa, J; Armstrong, T; Weickert, M; Butturini, G; Staettner, S; Boesch, F; Cives, M; Moulton, CA; He, J; Selberherr, A; Twito, O; Castaldi, A; Angelis, C; Gaujoux, S; Almeamar, H; Frilling, A; Vigia, E; Wilson, C; Muffatti, F; Srirajaskanthan, R; Invernizzi, P; Lania, A; Kwon, W; Ewald, J; Rinzivillo, M; Nessi, C; Smid, L; Gardini, A; Tsoli, M; Picardi, E; Hentic, O; Croagh, D; Toumpanakis, C; Citterio, D; Ramsey, E; Mosterman, B; Regi, P; Gasteiger, S; Rossi, R; Smiroldo, V; Jang, JY; Falconi, MIntroduction: The optimal treatment for small, asymptomatic, nonfunctioning pancreatic neuroendocrine neoplasms (NF-PanNEN) is still controversial. European Neuroendocrine Tumor Society (ENETS) guidelines recommend a watchful strategy for asymptomatic NF-PanNEN <2 cm of diameter. Several retrospective series demonstrated that a non-operative management is safe and feasible, but no prospective studies are available. Aim of the ASPEN study is to evaluate the optimal management of asymptomatic NF-PanNEN ≤2 cm comparing active surveillance and surgery. Methods: ASPEN is a prospective international observational multicentric cohort study supported by ENETS. The study is registered in ClinicalTrials.gov with the identification code NCT03084770. Based on the incidence of NF-PanNEN the number of expected patients to be enrolled in the ASPEN study is 1,000 during the study period (2017-2022). Primary endpoint is disease/progression-free survival, defined as the time from study enrolment to the first evidence of progression (active surveillance group) or recurrence of disease (surgery group) or death from disease. Inclusion criteria are: age >18 years, the presence of asymptomatic sporadic NF-PanNEN ≤2 cm proven by a positive fine-needle aspiration (FNA) or by the presence of a measurable nodule on high-quality imaging techniques that is positive at 68Gallium DOTATOC-PET scan. Conclusion: The ASPEN study is designed to investigate if an active surveillance of asymptomatic NF-PanNEN ≤2 cm is safe as compared to surgical approach.
- Pancreas Rejection in the Artificial Intelligence Era: New Tool for Signal Patients at RiskPublication . Vigia, E; Ramalhete, L; Ribeiro, R; Barros, I; Chumbinho, B; Filipe, E; Pena, A; Bicho, L; Nobre, A; Carrelha, S; Sobral, M; Lamelas, J; Coelho, JS; Ferreira, A; Pinto Marques, HIntroduction: Pancreas transplantation is currently the only treatment that can re-establish normal endocrine pancreatic function. Despite all efforts, pancreas allograft survival and rejection remain major clinical problems. The purpose of this study was to identify features that could signal patients at risk of pancreas allograft rejection. Methods: We collected 74 features from 79 patients who underwent simultaneous pancreas-kidney transplantation (SPK) and used two widely-applicable classification methods, the Naive Bayesian Classifier and Support Vector Machine, to build predictive models. We used the area under the receiver operating characteristic curve and classification accuracy to evaluate the predictive performance via leave-one-out cross-validation. Results: Rejection events were identified in 13 SPK patients (17.8%). In feature selection approach, it was possible to identify 10 features, namely: previous treatment for diabetes mellitus with long-term Insulin (U/I/day), type of dialysis (peritoneal dialysis, hemodialysis, or pre-emptive), de novo DSA, vPRA_Pre-Transplant (%), donor blood glucose, pancreas donor risk index (pDRI), recipient height, dialysis time (days), warm ischemia (minutes), recipient of intensive care (days). The results showed that the Naive Bayes and Support Vector Machine classifiers prediction performed very well, with an AUROC and classification accuracy of 0.97 and 0.87, respectively, in the first model and 0.96 and 0.94 in the second model. Conclusion: Our results indicated that it is feasible to develop successful classifiers for the prediction of graft rejection. The Naive Bayesian generated nomogram can be used for rejection probability prediction, thus supporting clinical decision making.
- Peritoneum Patch Repair in Oncologic Major Resections – An Autolog AlternativePublication . Aguiar, C; Vigia, E; Nobre, AM; Bicho, L; Filipe, E; Paulino, J
- Predicting Function Delay with a Machine Learning Model: Improve the Long-term Survival of Pancreatic GraftsPublication . Vigia, E; Ramalhete, L; Barros, I; Chumbinho, B; Filipe, E; Pena, A; Bicho, L; Nobre, A; Carrelha, S; Corado, S; Sobral, M; Lamelas, J; Santos Coelho, J; Pinto Marques, H; Pico, P; Costa, S; Rodrigues, F; Bigotte Vieira, M; Magriço, R; Cotovio, P; Caeiro, F; Aires, I; Silva, C; Remédio, F; Martins, A; Ferreira, A; Paulino, J; Nolasco, F; Ribeiro, RThe impact of delayed graft function on outcomes following various solid organ transplants is well documented and addressed in the literature. Delayed graft function following various solid organ transplants is associated with both short- and long-term graft survival issues. In a retrospective cohort study including 106 patients we evaluated whether pancreas graft survival differs according to moment of insulin therapy following simultaneous pancreaskidney transplant. As a result, we aimed to identify possible risk factors and build a machine-learning-based model that predicts the likelihood of dysfunction following SPK transplant patients based on day zero data after transplant, allowing to enhance pancreatic graft survival. Feature selection by Relief algorithm yielded donor features, age, cause of death, hemoglobin, gender, ventilation days, days in ICU, length of cardiac respiratory arrest and recipient features, gender, long-term insulin, dialysis type, time of diabetes mellitus, vPRA pre-Tx, number of HLA-A mismatches and PRDI, all contributed to the models' strength.
- Simultaneous Kidney-Pancreas Transplantation With an Original "Transverse Pancreas" Technique: Initial 9 Years' Experience With 56 CasesPublication . Paulino, J; Martins, A; Vigia, E; Marcelino, P; Nobre, AM; Bicho, L; Filipe, E; Barroso, EAn innovative technique for pancreas transplantation is described. The main aspect consists of the horizontal positioning of the pancreas, which allows a better venous outflow, thus preventing thrombosis and graft loss. The program of pancreas transplantation in this national reference center for pancreatic and liver surgery was started in 2007; the initial results were considered poor, resulting in the loss of half of the grafts due to venous thrombosis. After analyzing the possible causes, this technique was proposed and successfully implemented, reducing the postoperative complications, particularly the problem of venous thrombosis. A detailed description of the new surgical technique is provided. The main clinical and demographic characteristics of the 56 patients who underwent the surgery are analyzed. The incidence of venous thrombosis was 5.3% (3 patients) and graft loss was 3.5% (2 patients). Due to the good results, this technique became the standard surgery for transplantation of the pancreas in our center. The technique proved to be safe and successful. Due to the unique pancreas graft implantation, we called it "transverse pancreas surgery."