A. Sipahi - Academia.edu (original) (raw)
Papers by A. Sipahi
The Italian journal of gastroenterology
The aim of this work was to evaluate and compare the effects of a low calorie diet (1026 kcal), s... more The aim of this work was to evaluate and compare the effects of a low calorie diet (1026 kcal), simvastatin and ursodeoxycholic acid administration on biliary lipid secretion and cholic acid kinetics in dieting obese subjects. We studied 6 obese subjects before and after four weeks of a hypocaloric diet alone, after four weeks of diet plus ursodeoxycholic acid (900 mg/day) and after four weeks of diet plus simvastatin (40 mg/day), according to a Latin square design. The cholesterol saturation index was increased after diet alone, significantly reduced with diet plus ursodeoxycholic acid (p < 0.01), and unchanged during simvastatin administration. While the cholesterol output was reduced by all three regimens, diet plus ursodeoxycholic acid caused a significantly greater decrease than diet alone (p < 0.01). Cholic acid synthesis and bile acid secretion were decreased by diet and diet plus simvastatin (p < 0.05), but neither was affected by ursodeoxycholic acid. For cholic ac...
A snapshot of the nutritional status of Crohn’s disease among adolescents in Brazil: a prospectiv... more A snapshot of the nutritional status of Crohn’s disease among adolescents in Brazil: a prospective cross-sectional study
Background: Cytomegalovirus is highly prevalent virus and usually occurs in immunocompromised pat... more Background: Cytomegalovirus is highly prevalent virus and usually occurs in immunocompromised patients. The pathophysiology and treatment of inflammatory bowel disease often induce a state of immunosuppression. Because this, there are still doubts and controversies about the relationship between inflammatory bowel disease and cytomegalovirus. Aim: Evaluate the frequency of cytomegalovirus in patients with inflammatory bowel disease and identify correlations. Methods: Patients with inflammatory bowel disease underwent an interview, review of records and collection of blood and fecal samples. The search for cytomegalovirus was performed by IgG and IgM blood serology, by real-time PCR in the blood and by qualitative PCR in feces. Results were correlated with red blood cell levels, C-reactive protein levels, erythrocyte sedimentation rates and fecal calprotectin levels for each patient. Results: Among the 400 eligible patients, 249 had Crohn’s disease, and 151 had ulcerative colitis. In...
Lymphology, 1989
Measurement of cholesterol transport from plasma to intestinal lymph based on i.v. labeling with ... more Measurement of cholesterol transport from plasma to intestinal lymph based on i.v. labeling with radioactive beta-sitosterol was validated by the simultaneous i.v. administration of 4-14C-beta-sitosterol and of 1,2-3H-cholesterol to two rats with bile duct, intestinal lymph, duodenum and jugular vein cannulations. In 11 other rats undergoing intestinal lymph duct cannulation, each potential source of lymph cholesterol was determined 2-3 weeks after i.v. pulse administration of 1,2-3H-beta-sitosterol and 4-14C-cholesterol. For this purpose, lymph fat, after an intragastric infusion of cottonseed oil (1900mg), was used as a marker for total cholesterol mass transported into intestinal lymph. In these two experimental groups of rats, namely, in the absence and in the presence of supplemental dietary cholesterol, filtration of cholesterol from plasma to lymph and absorption of cholesterol derived from bile did not change in the presence of exogenous cholesterol. In other words, absorpti...
Revista do Hospital das Clinicas, 1975
Revista do Hospital das Clinicas, 1989
A 54 years old white woman and a 38 years old white man with short-bowel disease are reported. Bo... more A 54 years old white woman and a 38 years old white man with short-bowel disease are reported. Both of them were submitted to surgical procedures for urinary oxalate calculi. They presented malabsorption syndrome with steatorrhea and severe malnutrition. The patients received parenteral nutrition. The woman had also cholelithiasis and acute pancreatitis. The clinical and laboratory data are presented and the pathophysiology of short-bowel disease with emphasis on bile salts depletion, the effect of bile salts on colon oxalate absorption, and intestinal loss of water is commented. The management of short-bowel disease and the use of cholesteramine and the supplementary diet is discussed.
Etude de 5 patients atteints de malabsorption et de diarrhees. Pour 4 d'entre eux une laparot... more Etude de 5 patients atteints de malabsorption et de diarrhees. Pour 4 d'entre eux une laparotomie est indiquee et le diagnostic est celui d'un lymphome mediterraneen pour 3 d'entre eux
Gallbladder motility has largely been studied in recent years. Since the ultrasonographic method ... more Gallbladder motility has largely been studied in recent years. Since the ultrasonographic method can be used in gallbladder emptying studies, we investigated the reproducibility of the ultrasound method for measurement of gallbladder volume. The ultrasonographic method was highly reproducible (r = 0.97) and, due to its safeness and lack of use of radioactive agents, it is attractive option for gallbladder motility studies in conditions associated with increased frequency of cholelithiasis.
A study is made of the behavior of urinary excretion of D-xilose three and five hours after the i... more A study is made of the behavior of urinary excretion of D-xilose three and five hours after the ingestion of 5 and 25 g of the substance. Twenty individuals were studied, 13 as control having no intestinal mucosa disease and 7 with steatorrhea and enteric lesions histologically confirmed. An analysis of the results revealed that with both doses it is possible to reduce the test time from five to three hours and thus differentiate the controls from the group of patients. No secondary side effects were observed with 5 g, which were present in 30% (6 cases) of the patients with doses of 25 g. In view of the results the use of 5 g in the test is indicated in the 3 hour test. Under these conditions 95% (1, 645 D.P.) for the controls excreted less than 1, 030 g (21%) of the doses administered.
Lymphology, 1989
In rats with intestinal lymph-fistula and electrolyte and protein losses continuously replaced by... more In rats with intestinal lymph-fistula and electrolyte and protein losses continuously replaced by I.V. infusion, the plasma to lymph filtration of total protein, albumin, and cholesterol was similar after duodenal infusion of either long-chain (LCT) or medium-chain (MCT) triglyceride. Filtration of cholesterol into intestinal lacteals was also measured after pulsed I.V. administration of 14C-beta-sitosterol as an indirect marker for passage of lipoproteins into the lymph system. During intraduodenal administration of LCT and constant I.V. infusion of 125I-apo high density lipoprotein (HDL), intact plasma HDL appeared in lymph and contributed apo-LP to chylomicron formation. Nevertheless, most lymph apo-LP originated from local mucosal synthesis.
Journal of Lipid Research, 1979
Journal of Crohn's and Colitis, Jan 16, 2018
Journal of Crohn's and Colitis, 2020
Background Primary sclerosing cholangitis (PSC) is a chronic and progressive cholestatic disease ... more Background Primary sclerosing cholangitis (PSC) is a chronic and progressive cholestatic disease associated with inflammatory bowel diseases (IBD) in 70% of cases.1 When combined, they present as one distinct phenotypical disease referred to as PSC-IBD with milder clinical course, despite more extensive colonic involvement and an increased risk of malignancies. The aim of this study was to assess clinical features and long-term outcomes of PSC-IBD patients from a quaternary hospital in Brazil. Methods We retrospectively reviewed all PSC-IBD patients registered and followed-up in our outpatient clinic between January 2000 and July 2019. Conventional colonoscopic and histological criteria were used to diagnose IBD, whereas radiographic or histological criteria for PSC. Medical records were abstracted for the following data: demographic characteristics; duration, extent, and treatment of IBD; duration, extent, and treatment of PSC; colorectal neoplasia (dysplasia and cancer); surgical ...
Journal of Crohn's and Colitis, 2019
Poster presentations >300 in all patients where measured; (7) high proportion of patients receivi... more Poster presentations >300 in all patients where measured; (7) high proportion of patients receiving IV methylprednisolone 43.8% (66.7% combination); (8) significant proportion of patients requiring infliximab 21.5% (35% in combination therapy); (9) of those requiring infliximab, 64.3% (18/28) were male; (10) two patients with refractoriness to steroids and infliximab had vedolizumab; (11) colectomy rate 2.3% (3/130). Complete management and outcome data will be presented. Conclusions: Immunotherapy-related colitis is one of the more severe adverse events related to immunotherapy and a significant proportion of patients will require hospital admission. Steroid refractoriness is a significant problem and studies are required to elucidate optimum treatment regimens and escalation strategies. This has implications for standardisation of care and healthcare provision on already stretched budgets. Complete management and outcome data will be presented.
Revista do Hospital das Clínicas
In order to gain some insight into the possible influence of gastric emptying on gallbladder hypo... more In order to gain some insight into the possible influence of gastric emptying on gallbladder hypomotility in patients with Crohn's disease, the gastric emptying time (GET) was measured by means of ultrasonography in 10 healthy controls and 10 patients with Crohn's disease. No significant difference was observed between both mean values for GET studies (GET: controls, 165.0 min +/- 12.8; Crohn, 142.0 min +/- 11.5; p = 0.208) after ingestion of a liquid meal. Thus, the gallbladder hypomotility described in patients with Crohn's disease, after a liquid fatty-meal stimulus, can not be explained by prolonged gastric emptying time.
Revista do Hospital das Clínicas
Gallbladder motility has largely been studied in recent years. Since the ultrasonographic method ... more Gallbladder motility has largely been studied in recent years. Since the ultrasonographic method can be used in gallbladder emptying studies, we investigated the reproducibility of the ultrasound method for measurement of gallbladder volume. The ultrasonographic method was highly reproducible (r = 0.97) and, due to its safeness and lack of use of radioactive agents, it is attractive option for gallbladder motility studies in conditions associated with increased frequency of cholelithiasis.
Lymphology, 1989
In rats with intestinal lymph-fistula and electrolyte and protein losses continuously replaced by... more In rats with intestinal lymph-fistula and electrolyte and protein losses continuously replaced by I.V. infusion, the plasma to lymph filtration of total protein, albumin, and cholesterol was similar after duodenal infusion of either long-chain (LCT) or medium-chain (MCT) triglyceride. Filtration of cholesterol into intestinal lacteals was also measured after pulsed I.V. administration of 14C-beta-sitosterol as an indirect marker for passage of lipoproteins into the lymph system. During intraduodenal administration of LCT and constant I.V. infusion of 125I-apo high density lipoprotein (HDL), intact plasma HDL appeared in lymph and contributed apo-LP to chylomicron formation. Nevertheless, most lymph apo-LP originated from local mucosal synthesis.
The Italian journal of gastroenterology
The aim of this work was to evaluate and compare the effects of a low calorie diet (1026 kcal), s... more The aim of this work was to evaluate and compare the effects of a low calorie diet (1026 kcal), simvastatin and ursodeoxycholic acid administration on biliary lipid secretion and cholic acid kinetics in dieting obese subjects. We studied 6 obese subjects before and after four weeks of a hypocaloric diet alone, after four weeks of diet plus ursodeoxycholic acid (900 mg/day) and after four weeks of diet plus simvastatin (40 mg/day), according to a Latin square design. The cholesterol saturation index was increased after diet alone, significantly reduced with diet plus ursodeoxycholic acid (p < 0.01), and unchanged during simvastatin administration. While the cholesterol output was reduced by all three regimens, diet plus ursodeoxycholic acid caused a significantly greater decrease than diet alone (p < 0.01). Cholic acid synthesis and bile acid secretion were decreased by diet and diet plus simvastatin (p < 0.05), but neither was affected by ursodeoxycholic acid. For cholic ac...
A snapshot of the nutritional status of Crohn’s disease among adolescents in Brazil: a prospectiv... more A snapshot of the nutritional status of Crohn’s disease among adolescents in Brazil: a prospective cross-sectional study
Background: Cytomegalovirus is highly prevalent virus and usually occurs in immunocompromised pat... more Background: Cytomegalovirus is highly prevalent virus and usually occurs in immunocompromised patients. The pathophysiology and treatment of inflammatory bowel disease often induce a state of immunosuppression. Because this, there are still doubts and controversies about the relationship between inflammatory bowel disease and cytomegalovirus. Aim: Evaluate the frequency of cytomegalovirus in patients with inflammatory bowel disease and identify correlations. Methods: Patients with inflammatory bowel disease underwent an interview, review of records and collection of blood and fecal samples. The search for cytomegalovirus was performed by IgG and IgM blood serology, by real-time PCR in the blood and by qualitative PCR in feces. Results were correlated with red blood cell levels, C-reactive protein levels, erythrocyte sedimentation rates and fecal calprotectin levels for each patient. Results: Among the 400 eligible patients, 249 had Crohn’s disease, and 151 had ulcerative colitis. In...
Lymphology, 1989
Measurement of cholesterol transport from plasma to intestinal lymph based on i.v. labeling with ... more Measurement of cholesterol transport from plasma to intestinal lymph based on i.v. labeling with radioactive beta-sitosterol was validated by the simultaneous i.v. administration of 4-14C-beta-sitosterol and of 1,2-3H-cholesterol to two rats with bile duct, intestinal lymph, duodenum and jugular vein cannulations. In 11 other rats undergoing intestinal lymph duct cannulation, each potential source of lymph cholesterol was determined 2-3 weeks after i.v. pulse administration of 1,2-3H-beta-sitosterol and 4-14C-cholesterol. For this purpose, lymph fat, after an intragastric infusion of cottonseed oil (1900mg), was used as a marker for total cholesterol mass transported into intestinal lymph. In these two experimental groups of rats, namely, in the absence and in the presence of supplemental dietary cholesterol, filtration of cholesterol from plasma to lymph and absorption of cholesterol derived from bile did not change in the presence of exogenous cholesterol. In other words, absorpti...
Revista do Hospital das Clinicas, 1975
Revista do Hospital das Clinicas, 1989
A 54 years old white woman and a 38 years old white man with short-bowel disease are reported. Bo... more A 54 years old white woman and a 38 years old white man with short-bowel disease are reported. Both of them were submitted to surgical procedures for urinary oxalate calculi. They presented malabsorption syndrome with steatorrhea and severe malnutrition. The patients received parenteral nutrition. The woman had also cholelithiasis and acute pancreatitis. The clinical and laboratory data are presented and the pathophysiology of short-bowel disease with emphasis on bile salts depletion, the effect of bile salts on colon oxalate absorption, and intestinal loss of water is commented. The management of short-bowel disease and the use of cholesteramine and the supplementary diet is discussed.
Etude de 5 patients atteints de malabsorption et de diarrhees. Pour 4 d'entre eux une laparot... more Etude de 5 patients atteints de malabsorption et de diarrhees. Pour 4 d'entre eux une laparotomie est indiquee et le diagnostic est celui d'un lymphome mediterraneen pour 3 d'entre eux
Gallbladder motility has largely been studied in recent years. Since the ultrasonographic method ... more Gallbladder motility has largely been studied in recent years. Since the ultrasonographic method can be used in gallbladder emptying studies, we investigated the reproducibility of the ultrasound method for measurement of gallbladder volume. The ultrasonographic method was highly reproducible (r = 0.97) and, due to its safeness and lack of use of radioactive agents, it is attractive option for gallbladder motility studies in conditions associated with increased frequency of cholelithiasis.
A study is made of the behavior of urinary excretion of D-xilose three and five hours after the i... more A study is made of the behavior of urinary excretion of D-xilose three and five hours after the ingestion of 5 and 25 g of the substance. Twenty individuals were studied, 13 as control having no intestinal mucosa disease and 7 with steatorrhea and enteric lesions histologically confirmed. An analysis of the results revealed that with both doses it is possible to reduce the test time from five to three hours and thus differentiate the controls from the group of patients. No secondary side effects were observed with 5 g, which were present in 30% (6 cases) of the patients with doses of 25 g. In view of the results the use of 5 g in the test is indicated in the 3 hour test. Under these conditions 95% (1, 645 D.P.) for the controls excreted less than 1, 030 g (21%) of the doses administered.
Lymphology, 1989
In rats with intestinal lymph-fistula and electrolyte and protein losses continuously replaced by... more In rats with intestinal lymph-fistula and electrolyte and protein losses continuously replaced by I.V. infusion, the plasma to lymph filtration of total protein, albumin, and cholesterol was similar after duodenal infusion of either long-chain (LCT) or medium-chain (MCT) triglyceride. Filtration of cholesterol into intestinal lacteals was also measured after pulsed I.V. administration of 14C-beta-sitosterol as an indirect marker for passage of lipoproteins into the lymph system. During intraduodenal administration of LCT and constant I.V. infusion of 125I-apo high density lipoprotein (HDL), intact plasma HDL appeared in lymph and contributed apo-LP to chylomicron formation. Nevertheless, most lymph apo-LP originated from local mucosal synthesis.
Journal of Lipid Research, 1979
Journal of Crohn's and Colitis, Jan 16, 2018
Journal of Crohn's and Colitis, 2020
Background Primary sclerosing cholangitis (PSC) is a chronic and progressive cholestatic disease ... more Background Primary sclerosing cholangitis (PSC) is a chronic and progressive cholestatic disease associated with inflammatory bowel diseases (IBD) in 70% of cases.1 When combined, they present as one distinct phenotypical disease referred to as PSC-IBD with milder clinical course, despite more extensive colonic involvement and an increased risk of malignancies. The aim of this study was to assess clinical features and long-term outcomes of PSC-IBD patients from a quaternary hospital in Brazil. Methods We retrospectively reviewed all PSC-IBD patients registered and followed-up in our outpatient clinic between January 2000 and July 2019. Conventional colonoscopic and histological criteria were used to diagnose IBD, whereas radiographic or histological criteria for PSC. Medical records were abstracted for the following data: demographic characteristics; duration, extent, and treatment of IBD; duration, extent, and treatment of PSC; colorectal neoplasia (dysplasia and cancer); surgical ...
Journal of Crohn's and Colitis, 2019
Poster presentations >300 in all patients where measured; (7) high proportion of patients receivi... more Poster presentations >300 in all patients where measured; (7) high proportion of patients receiving IV methylprednisolone 43.8% (66.7% combination); (8) significant proportion of patients requiring infliximab 21.5% (35% in combination therapy); (9) of those requiring infliximab, 64.3% (18/28) were male; (10) two patients with refractoriness to steroids and infliximab had vedolizumab; (11) colectomy rate 2.3% (3/130). Complete management and outcome data will be presented. Conclusions: Immunotherapy-related colitis is one of the more severe adverse events related to immunotherapy and a significant proportion of patients will require hospital admission. Steroid refractoriness is a significant problem and studies are required to elucidate optimum treatment regimens and escalation strategies. This has implications for standardisation of care and healthcare provision on already stretched budgets. Complete management and outcome data will be presented.
Revista do Hospital das Clínicas
In order to gain some insight into the possible influence of gastric emptying on gallbladder hypo... more In order to gain some insight into the possible influence of gastric emptying on gallbladder hypomotility in patients with Crohn's disease, the gastric emptying time (GET) was measured by means of ultrasonography in 10 healthy controls and 10 patients with Crohn's disease. No significant difference was observed between both mean values for GET studies (GET: controls, 165.0 min +/- 12.8; Crohn, 142.0 min +/- 11.5; p = 0.208) after ingestion of a liquid meal. Thus, the gallbladder hypomotility described in patients with Crohn's disease, after a liquid fatty-meal stimulus, can not be explained by prolonged gastric emptying time.
Revista do Hospital das Clínicas
Gallbladder motility has largely been studied in recent years. Since the ultrasonographic method ... more Gallbladder motility has largely been studied in recent years. Since the ultrasonographic method can be used in gallbladder emptying studies, we investigated the reproducibility of the ultrasound method for measurement of gallbladder volume. The ultrasonographic method was highly reproducible (r = 0.97) and, due to its safeness and lack of use of radioactive agents, it is attractive option for gallbladder motility studies in conditions associated with increased frequency of cholelithiasis.
Lymphology, 1989
In rats with intestinal lymph-fistula and electrolyte and protein losses continuously replaced by... more In rats with intestinal lymph-fistula and electrolyte and protein losses continuously replaced by I.V. infusion, the plasma to lymph filtration of total protein, albumin, and cholesterol was similar after duodenal infusion of either long-chain (LCT) or medium-chain (MCT) triglyceride. Filtration of cholesterol into intestinal lacteals was also measured after pulsed I.V. administration of 14C-beta-sitosterol as an indirect marker for passage of lipoproteins into the lymph system. During intraduodenal administration of LCT and constant I.V. infusion of 125I-apo high density lipoprotein (HDL), intact plasma HDL appeared in lymph and contributed apo-LP to chylomicron formation. Nevertheless, most lymph apo-LP originated from local mucosal synthesis.