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1.
Food Chem ; 439: 138066, 2024 May 01.
Artículo en Inglés | MEDLINE | ID: mdl-38035493

RESUMEN

The complex crystal structure of coca butter (CB) is responsible for the unique melting behavior, surface gloss, and mechanical properties of chocolate. While most studies concentrated on the crystalline state of CB, few studied the isotropic liquid state, which has a major impact on the crystallization process and the characteristics of the resulting crystals. In this study, the molecular organizations of the main CB triacylglycerols (TAGs; 1,3-dipalmitoyl-2-oleoylglycerol, palmitoyl-oleoyl-stearoylglycerol, POS, and 1,3-distearoyl-2-oleoylglycerol) were studied. The findings revealed the tunning-fork (Tf) conformation, commonly found in the crystalline state, is the least abundant in the isotropic liquid state of CB and pure TAGs. Notably, POS was found to interact with itself in CB, while its molecules with Tf conformation, although in small amounts in the mixture, tend to pair with each other at lower temperatures. These results highlight the significance of POS in CB crystallization and provide insights for developing CB alternatives.


Asunto(s)
Cacao , Coca , Cocaína , Grasas de la Dieta/análisis , Triglicéridos/química , Cristalización , Cacao/química
4.
ACS Omega ; 7(48): 44180-44186, 2022 Dec 06.
Artículo en Inglés | MEDLINE | ID: mdl-36506152

RESUMEN

6,7-Dehydroroyleanone (DHR) is a caspase-induced cytotoxic abietane diterpene, frequently found on Plectranthus spp. A pharmaceutical formulation consisting of a DHR-squalene conjugate was synthesized and analyzed by different techniques such as scanning electron microscopy (SEM). The facile production of the dispersion of DHR-squalene conjugate nanoparticles in phosphate buffer (pH 7.4) suggests that this nanodelivery platform may be an effective system to improve the solubility and bioavailability of DHR, so that therapeutical systemic levels may be achieved.

5.
ACS Appl Mater Interfaces ; 14(45): 50836-50848, 2022 Nov 16.
Artículo en Inglés | MEDLINE | ID: mdl-36331877

RESUMEN

Investments in the transfer and storage of thermal energy along with renewable energy sources strengthen health and economic infrastructure. These factors intensify energy diversification and the more rapid post-COVID recovery of economies. Ionanofluids (INFs) composed of long multiwalled carbon nanotubes (MWCNTs) rich in sp2-hybridized atoms and ionic liquids (ILs) display excellent thermal conductivity enhancement with respect to the pure IL, high thermal stability, and attractive rheology. However, the influence of the morphology, physicochemistry of nanoparticles and the IL-nanostructure interactions on the mechanism of heat transfer and rheological properties of INFs remain unidentified. Here, we show that intertube nanolayer coalescence, supported by 1D geometry assembly, leads to the subzipping of MWCNT bundles and formation of thermal bridges toward 3D networks in the whole INF volume. We identified stable networks of straight and bent MWCNTs separated by a layer of ions at the junctions. We found that the interactions between the ultrasonication-induced breaking nanotubes and the cations were covalent in nature. Furthermore, we found that the ionic layer imposed by close MWCNT surfaces favored enrichment of the cis conformer of the bis(trifluoromethylsulfonyl)imide anion. Our results demonstrate how the molecular perfection of the MWCNT structure with its supramolecular arrangement affects the extraordinary thermal conductivity enhancement of INFs. Thus, we gave the realistic description of the interactions at the IL-CNT interface with its (super)structure and chemistry as well as the molecular structure of the continuous phase. We anticipate our results to be a starting point for more complex studies on the supramolecular zipping mechanism. For example, ionically functionalized MWCNTs toward polyionic systems─of projected and controlled nanolayers─could enable the design of even more efficient heat-transfer fluids and miniaturization of flexible electronics.

6.
J Chem Inf Model ; 62(6): 1471-1478, 2022 03 28.
Artículo en Inglés | MEDLINE | ID: mdl-35239343

RESUMEN

Preparing input files for molecular dynamics (MD) simulations can be a tedious task, particularly if different MD programs need to be used. Most simulation packages are accompanied by applications that handle this task, and, in some cases, software to perform interconversion between MD programs can be found. However, the conversion between different types of files is not always foolproof or the force field may not be fully supported, as quite often observed with polarization models. This work describes the program DLPGEN, which produces input files for the MD programs GROMACS, CHARMM, DL_POLY, and LAMMPS. The program can prepare polarizable force fields using a self-consistent field approach or with a dual thermostat-extended Lagrangian model. For GROMACS, a new polarization scheme suitable for the simulation of molecules containing more than one virtual particle is described. Results obtained for ethanol in the liquid state revealed that the system configurational energy, liquid density, and self-diffusion coefficient obtained with GROMACS are in good agreement with the data found with LAMMPS and CHARMM. In the case of DL_POLY, a problem with the Shells temperature control was found, suggesting that this program may not be suitable for the simulation of molecules containing multiple Drude particles.


Asunto(s)
Simulación de Dinámica Molecular , Programas Informáticos
7.
J Phys Chem B ; 125(41): 11491-11497, 2021 10 21.
Artículo en Inglés | MEDLINE | ID: mdl-34636241

RESUMEN

The knowledge of water solubility in ionic liquids (ILs) is an important property with an impact on the design of many physical and chemical processes, like the purification of organic compounds or the establishment of decontamination procedures. The development of methods to predict or establish solubility trends in ILs is, therefore, extremely relevant, as it may avoid expensive and time-consuming experimental procedures. In this work, we compare results of water solubility in ILs predicted by a quantitative structure-property relationship (QSPR) model with trends found using aggregation studies in molecular dynamics (MD) simulation results. This study was performed for ILs combining the cations 1-butyl-1-methylpyrrolidinium and 1-butyl-1-methylmorpholinium, with the anions bis(pentafluoroethylsulfonyl)imide (BETI-), trifluoromethanesulfonate (TF-), and tetrafluoroborate (BF4-). Both methods indicated that, at 298.15 K, the water solubility in ILs was almost independent of the investigated cations. However, if the IL is composed of a hydrophobic anion, a slight increase in the mixability of the IL with water may be observed if the cation can form H-bonds. The QSPR model indicated that the hydrophobic BETI- anion leads to solubilities (xH2O ∼ 0.33), approximately half of those predicted when the cations are combined with TF- and BF4- anions (xH2O ∼ 0.60). The MD results suggested that this difference is essentially related to the ability of the water molecules to interact with the anion. This interaction involves the formation of networks of molecules, where H2O is completely solvated by anions. These structures make the formation of interactions between water molecules difficult, which are responsible for their segregation from solution and, therefore, to liquid-liquid phase separation. For the investigated ILs, the MD data also suggest that the solubility trends are inversely proportional to the number of "isolated" anions relative to ···AN-H2O-AN-H2O··· networks.


Asunto(s)
Líquidos Iónicos , Aniones , Simulación de Dinámica Molecular , Solubilidad , Agua
8.
Molecules ; 26(18)2021 Sep 21.
Artículo en Inglés | MEDLINE | ID: mdl-34577186

RESUMEN

The energetics of the stepwise dissociation of a A:B2 bi-component crystal, according to A:B2(cr) → A:B(cr) + B(cr) and A:B(cr) → A(cr) + B(cr), was investigated using MA:Phe2 and MA:Phe (MA = maleic acid; Phe = L-phenylalanine) as model systems. The enthalpy changes associated with these sequential processes and with the overall dissociation reaction A:B2(cr) → A(cr) + 2B(cr) were determined by solution calorimetry. It was found that they are all positive, indicating that there is a lattice enthalpy gain when MA:Phe2 is formed, either from the individual precursors or by adding Phe to MA:Phe. Single-crystal X-ray diffraction (SCXRD) analysis showed that MA:Phe2 is best described as a protic salt containing a maleate anion (MA-) and two non-equivalent L-phenylalanine units, both linked to MA- by NH···O hydrogen bonds (H-bond): one of these units is protonated (HPhe+) and the other zwitterionic (Phe±). Only MA- and HPhe+ molecules are present in the MA:Phe lattice. In this case, however, NH···O and OH···O H-bonds are formed between each MA- unit and two HPhe+ molecules. Despite these structural differences, the enthalpy cost for the removal of the zwitterionic Phe± unit from the MA:Phe2 lattice to yield MA:Phe is only 0.9 ± 0.4 kJ mol-1 higher than that for the dissociation of MA:Phe, which requires a proton transfer from HPhe+ to MA- and the rearrangement of L-phenylalanine to the zwitterionic, Phe±, form. Finally, a comparison of the dissociation energetics and structures of MA:Phe and of the previously reported glycine maleate (MA:Gly) analogue indicated that parameters, such as the packing coefficient, density, hydrogen bonds formed, or fusion temperature, are not necessarily good descriptors of dissociation enthalpy or lattice enthalpy trends when bi-component crystals with different molecular composition are being compared, even if the stoichiometry is the same.

9.
Chemphyschem ; 22(21): 2190-2200, 2021 11 04.
Artículo en Inglés | MEDLINE | ID: mdl-34464013

RESUMEN

This work comprises the study of solubilities of gases in ionic liquids (ILs) using a chemoinformatic approach. It is based on the codification, of the atomic inter-component interactions, cation/gas and anion/gas, which are used to obtain a pattern of activation in a Kohonen Neural Network (MOLMAP descriptors). A robust predictive model has been obtained with the Random Forest algorithm and used the maximum proximity as a confidence measure of a given chemical system compared to the training set. The encoding method has been validated with molecular dynamics. This encoding approach is a valuable estimator of attractive/repulsive interactions of a generical chemical system IL+gas. This method has been used as a fast/visual form of identification of the reasons behind the differences observed between the solubility of CO2 and O2 in 1-butyl-3-methylimidazolium hexafluorophosphate (BMIM PF6 ) at identical temperature and pressure (TP) conditions, The effect of variable cation and anion effect has been evaluated.

10.
Phys Chem Chem Phys ; 22(43): 25236-25242, 2020 Nov 21.
Artículo en Inglés | MEDLINE | ID: mdl-33135034

RESUMEN

Liquid-liquid phase behavior measurements were performed for binary mixtures of water and ionic liquids (ILs) containing the same 1-ethyl-3-methylimidazolium ([C2mim]+) cation and different imide-based anions, having symmetric (bis(fluorosulfonyl)imide ([FSI]-)) or asymmetric structures (2,2,2-trifluoromethylsulfonyl-N-cyanoamide ([TFSAM]-) and 2,2,2-trifluoro-N-(trifluoromethylsulfonyl)acetamide ([TSAC]-)). An inversion of phase behavior was observed: while below ∼298 K, the miscibility of water in the studied ILs increases according to the order [C2mim][TSAC] < [C2mim][FSI] < [C2mim][NTf2], for temperatures above ∼303 K, the reverse trend is observed [C2mim][NTf2] < [C2mim][FSI] < [C2mim][TSAC]. In turn, above ∼306 K the [C2mim][TFSAM] is completely miscible with H2O in all ranges of concentrations. The obtained results also revealed an unusual water solubility variation of 11% in [C2mim][FSI], and 20% in [C2mim][TSAC], when the system temperature was changed by less than 1 K, around 298 K and 301 K, respectively. Molecular Dynamics (MD) simulations were used to understand the IL-water interactions and rationalize the experimental observations. These results suggested that the miscibility trends are mainly related to the ability of the water molecules to form water-anion and water-water aggregates in solution.

11.
GE Port J Gastroenterol ; 27(5): 299-301, 2020 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-32999900
12.
GE Port J Gastroenterol ; 27(5): 324-335, 2020 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-32999905

RESUMEN

The present evidence-based guidelines are focused on the use of device-assisted enteroscopy in the management of small-bowel diseases. A panel of experts selected by the Spanish and Portuguese small bowel study groups reviewed the available evidence focusing on the main indications of this technique, its role in the management algorithm of each indication and on its diagnostic and therapeutic yields. A set of recommendations were issued accordingly.


Estas recomendações baseadas na evidência detalham o uso da enteroscopia assistida por dispositivo no manejo clínico das doenças do intestino delgado. Um conjunto de Gastrenterologistas diferenciados em patologia do intestino delgado foi selecionado pelos grupos de estudos Espanhol e Portugués de intestino delgado para rever a evidência disponível sobre as principais indicações desta técnica, o seu papel nos algoritmos de manejo de cada indicação e sobre o seu rendimento diagnóstico e terapêutico. Foi gerado um conjunto de recomendações pelos autores.

13.
GE Port J Gastroenterol ; 27(5): 364-367, 2020 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-32999910

RESUMEN

INTRODUCTION: Cytomegalovirus (CMV) is the most common opportunistic agent in HIV-infected patients. It can affect the entire gastrointestinal tract, but frequently involves the oesophagus and the colon. CASE REPORT: We report the case of a 70-year-old female, ultimately diagnosed with HIV infection, whose inaugural clinical manifestation was CMV colitis with endoscopic findings resembling a rectal tumour in which initial histological evaluation was not able to provide a proper diagnosis. DISCUSSION/CONCLUSION: Since clinical presentation is variable and histopathological yield without immunohistochemical analysis is poor, recognizing CMV infection in the absence of known risk factors may be difficult. It is crucial to consider this entity with suspicious lesions or when initial evaluation, either clinical or histopathological, is inconclusive, thus avoiding potentially debilitating and superfluous treatment or life-threatening complications.


INTRODUÇÃO: O citomegalovírus (CMV) é o agente oportunista mais comum nos doentes com infeção pelo virus da imunodeficiência humana (VIH). Pode afetar todo o trato gastrointestinal, mas frequentemente envolve o esófago e o cólon. CASO CLÍNICO: Os autores apresentam o caso de uma doente do sexo feminino com 70 anos, com diagnóstico final de infeção por VIH, cuja manifestação clínica inaugural foi colite a CMV, com achados endoscópicos iniciais mimetizando um tumor rectal. DISCUSSÃO/CONCLUSÃO: Uma vez que a apresentação clínica é variável e a rentabilidade da análise histopatológica sem imunohistoquímica é baixa, o reconhecimento da infeção por CMV na ausência de fatores de risco pode ser difícil. É crucial considerar esta entidade perante lesões suspeitas ou quando a avaliação inicial, clínica ou histopatológica, for inconclusiva, de forma a evitar potenciais terapêuticas debilitantes e/ou supérfluas bem como complicações graves.

14.
Rev Esp Enferm Dig ; 112(4): 309-318, 2020 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-32188259

RESUMEN

The present evidence-based guidelines are focused on the use of device-assisted enteroscopy in the management of small-bowel diseases. A panel of experts selected by the Spanish and Portuguese small-bowel study groups reviewed the available evidence focusing on the main indications of this technique, its role in the management algorithm of each indication, and its diagnostic and therapeutic yield. A set of recommendations was issued accordingly.


Asunto(s)
Endoscopía Capsular , Enfermedades Intestinales , Humanos , Enfermedades Intestinales/diagnóstico por imagen , Enfermedades Intestinales/terapia , Intestino Delgado/diagnóstico por imagen , Portugal
15.
Phys Chem Chem Phys ; 22(2): 758-771, 2020 Jan 02.
Artículo en Inglés | MEDLINE | ID: mdl-31833502

RESUMEN

An accurate prediction of the mechanical behavior of long carbyne chains depends on the suitable modeling of bond alternation in these chains. While first-principles methods are a good approach, less computationally demanding empirical potentials are preferable for large carbyne-containing systems. AIREBO and Reax empirical potentials have extensively and successfully been used for simulating the mechanical behavior of graphene and carbon nanotubes. However, it remains unclear if these potentials can be directly applied in the accurate mechanical modeling of carbon nanostructures with sp hybridization, without re-parameterization. Here, a new force-field for carbyne, designated as C13 potential, that takes bond alternation into account, is presented. This new empirical potential was parameterized from ab initio calculations. Molecular dynamics (MD) simulations using the developed force-field are then conducted to determine the mechanical properties of carbyne chains under tensile loading, namely to assess their dependence on chain length and temperature. The bending stiffness of carbyne and its persistence length are also calculated. The results obtained are validated through comparison with results available in the literature. Lastly, the C13 potential is employed to model, for the first time, the tensile and the compressive behaviors of the hybrid system composed of carbon nanotubes infilled with carbyne chains.

17.
Phys Chem Chem Phys ; 21(42): 23305-23309, 2019 Nov 14.
Artículo en Inglés | MEDLINE | ID: mdl-31617553

RESUMEN

Simple mixtures of ionic liquids (IL-IL mixtures) can become a promising approach for the substitution of task-specific ILs. Such a concept was explored in this article by comparison of the thermophysical properties of neat 1-ethyl-3-methylimidazolium 2,2,2-trifluoromethylsulfonyl-N-cyanoamide, [C2mim][TFSAM], and equimolar mixtures of two structurally similar ILs having more common ions. Molecular dynamics (MD) simulations were additionally used to further highlight structural aspects of these systems at a molecular level.

18.
Mol Pharm ; 15(11): 5349-5360, 2018 11 05.
Artículo en Inglés | MEDLINE | ID: mdl-30230340

RESUMEN

Simvastatin is one of the most widely used active pharmaceutical ingredients for the treatment of hyperlipidemias. Because the compound is employed as a solid in drug formulations, particular attention should be given to the characterization of different polymorphs, their stability domains, and the nature of the phase transitions that relate them. In this work, the phase transitions delimiting the stability domains of three previously reported simvastatin forms were investigated from structural, energetics, and dynamical points of view based on single crystal X-ray diffraction (SCXRD), hot stage microscopy (HSM), and differential scanning calorimetry (DSC) experiments (conventional scans and heat capacity measurements), complemented with molecular dynamics (MD) simulations. Previous assignments of the crystal forms were confirmed by SCXRD: forms I and II were found to be orthorhombic ( P212121, Z'/ Z = 1/4) and form III was monoclinic ( P21, Z'/ Z = 2/4). The obtained results further indicated that (i) the transitions between different forms are observed at 235.9 ± 0.1 K (form III → form II) and at 275.2 ± 0.2 K (form II → form I) in DSC runs carried out at 10 K min-1 and close to these values when other types of techniques are used (e.g., HSM). (ii) They are enantiotropic (i.e., there is a transition temperature relating the two phases before fusion at which the stability order is reversed), fast, reversible, with very little hysteresis between heating and cooling modes, and occur under single crystal to single crystal conditions. (iii) A nucleation and growth mechanism seems to be followed since HSM experiments on single crystals evidenced the propagation of an interface, accompanied by a change of birefringence and crystal contraction or expansion (more subtle in the case of form III → form II), when the phase transitions are triggered. (iv) Consistent with the reversible and small hysteresis nature of the phase transitions, the SCXRD results indicated that the molecular packing is very similar in all forms and the main structural differences are associated with conformational changes of the "ester tail". (v) The MD simulations further suggested that the tail is essentially "frozen" in two conformations below the III → II transition temperature, becomes progressively less hindered throughout the stability domain of form II, and acquires a large conformational freedom above the II → I transition. Finally, the fact that these transitions were found to be fast and reversible suggests that polymorphism is unlikely to be a problem for pharmaceutical formulations employing crystalline simvastatin because, if present, the III and II forms will readily convert to form I at ambient temperature.


Asunto(s)
Composición de Medicamentos , Inhibidores de Hidroximetilglutaril-CoA Reductasas/química , Simvastatina/química , Rastreo Diferencial de Calorimetría , Química Farmacéutica , Enlace de Hidrógeno , Conformación Molecular , Simulación de Dinámica Molecular , Estructura Molecular , Transición de Fase , Temperatura de Transición , Difracción de Rayos X
19.
GE Port J Gastroenterol ; 25(4): 175-178, 2018 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-29998162

RESUMEN

INTRODUCTION: Systemic inflammatory diseases are related to an increased risk of lymphoproliferative disorders. Although inflammatory bowel disease (IBD) was also associated with these conditions, population-based studies failed to demonstrate this relationship, and most studies only identified a very small number of cases. In the last few years, concerns arose regarding the role of thiopurines and tumour necrosis factor-alpha (TNF-α)-blocking agents in the development of lymphoma, influencing therapeutic decisions in IBD patients. The aim of this study was to describe a case series of IBD patients who developed a lymphoproliferative disorder in our tertiary referral centre. MATERIAL AND METHODS: The clinical records of all IBD patients who were observed in our unit between January 2007 and December 2016 were retrospectively reviewed, and IBD subjects who were diagnosed with a lymphoproliferative disorder were selected. Clinical and demographic data regarding both conditions were collected. RESULTS: Six IBD patients were diagnosed with a lymphoma - 4 Hodgkin lymphomas and 2 B-cell non-Hodgkin lymphomas - of which 3 corresponded to primary colonic lymphomas. Immunohistochemical analysis detected the presence of Epstein-Barr virus in the tumour cells of 2 patients, both of them with Hodgkin lymphomas. Only 2 patients were previously treated with thiopurines or anti-TNF-α drugs; none of the remaining had any history of immunosuppressive treatment. DISCUSSION AND CONCLUSIONS: Despite major attention being currently focused on the effect of treatment, which may play the main role in the increased susceptibility to lymphoma in IBD patients, and although it may be difficult to demonstrate, IBD itself may contribute to the development of lymphoproliferative disorders, particularly primary intestinal lymphomas.


INTRODUÇÃO: Doenças inflamatórias crónicas estão relacionadas com um aumento de risco de doenças linfoproliferativas. Apesar da doença inflamatória intestinal (DII) também ter sido associada a estas complicações, estudos de base populacional falharam em demonstrar esta relação, e a maioria dos estudos apenas identificou um baixo número de casos. Nos últimos anos, preocupações foram levantadas no que diz respeito ao papel das tiopurinas e dos bloqueadores do factor de necrose tumoral alpha (TNF-α) no desenvolvimento de linfomas, influenciando decisões terapêuticas em doentes com DII. O objectivo deste estudo foi o de descrever uma série de casos de doentes com DII que desenvolveram doenças linfoproliferativas num centro de referência. MATERIAL E MÉTODOS: Os registos clínicos dos doentes que foram observados na nossa unidade entre Janeiro de 2007 e Dezembro de 2016 foram retrospectivamente analisados, tendo sido seleccionados os doentes diagnosticados com uma doença linfoproliferativa. Os dados clínicos e demográficos respeitantes a ambas as condições foram colectados. RESULTADOS: Seis doentes com DII foram diagnosticados com linfoma - 4 linfomas de Hodgkin e 2 linfomas não-Hodgkin de células B -, dos quais 3 corresponderam a linfomas primários do cólon. Análise imunohistoquímica detectou a presença do vírus Epstein-Barr nas células tumorais de 2 doentes, ambos com linfoma de Hodgkin. Apenas 2 doentes tinham recebido tratamento prévio com tiopurinas ou agentes anti-TNF-α; nenhum dos restantes tinha qualquer história de terapêutica imunossupressora. DISCUSSÃO E CONCLUSÃO: Apesar da maioria das atenções estar focada no efeito do tratamento, o qual será o principal responsável pela maior susceptibilidade para linfomas em doentes com DII, e apesar da dificuldade em demonstrá-lo, a própria DII poderá contribuir para o desenvolvimento de doenças linfoproliferativas, particular de linfomas intestinais primários.

20.
GE Port J Gastroenterol ; 25(2): 91-95, 2018 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-29662934

RESUMEN

Rendu-Osler-Weber disease, also known as hereditary hemorrhagic telangiectasia, is a rare autosomal dominant disorder which is often characterized by recurrent epistaxis, mucocutaneous and gastrointestinal telangiectasias, and visceral arteriovenous malformations. Patients with gastrointestinal involvement can present with a wide spectrum of severity, which may vary from uncomplicated iron deficiency anemia to continuous and refractory bleeding. We present the case of a 62-year-old female, who was admitted with anemia following several episodes of melena, and whose endoscopic examination revealed multiple angiodysplasias in the stomach and small bowel. Despite endoscopic and medical treatment attempts with hormonal agents and octreotide, she developed persistent hemorrhage and severe anemia, requiring frequent red blood cell transfusions. Immediately after initiating bevacizumab (7.5 mg/kg, every 3 weeks), complete cessation of bleeding episodes was observed. Currently, after 1 year of follow-up, she maintained sustained remission without the occurrence of adverse events.


A doença de Rendu-Osler-Weber, também conhecida por telangiectasia hemorrágica hereditária, é uma doença autossómica dominante rara, frequentemente caracterizada por epistáxis recorrente, telangiectasias mucocutâneas e gastrointestinais e malformações arteriovenosas viscerais. Doentes com envolvimento gastrointestinal podem apresentar um amplo espectro de gravidade, que pode variar de anemia ferropénica não complicada até hemorragia persistente e refractária. Os autores apresentam o caso de uma mulher de 62 anos, admitida por anemia na sequência de vários episódios de melenas, cuja avaliação endoscópica revelou múltiplas angiodisplasias no estômago e intestino delgado. Apesar de várias tentativas de terapêutica endoscópica e médica com agentes hormonais e octreotido, evoluiu para hemorragia persistente e anemia grave, com necessidade de suporte transfusional frequente. Imediatamente após ter iniciado bevacizumab (7,5 mg/kg, a cada 3 semanas) ocorreu cessação total dos episódios de hemorragia. Actualmente, após um ano de follow-up, mantém remissão sustentada sem a ocorrência de quaisquer eventos adversos.

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