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Preoperative albumin-bilirubin score is a prognostic factor for gastric cancer patients after curative gastrectomy

World Journal of Gastrointestinal Surgery 2023年第6期15卷 1125-1137页

作者： Daniel Jose Szor Marina Alessandra Pereira Marcus Fernando Kodama Pertille Ramos Francisco Tustumi andre roncon dias Bruno Zilberstein Ulysses Ribeiro Jr Department of Gastroenterology Instituto do CancerHospital das Clinicas HCFMUSPFaculdade de MedicinaUniversidade de Sao PauloSao Paulo 01246000Brazil

BACKGROUND Albumin-bilirubin(ALBI)score is an indicator of liver dysfunction and is useful for predicting prognosis of hepatocellular ***,this liver function index has been used to predict prognosis in other ***,the significance of ALBI score in gastric cancer(GC)after radical resection has not been *** To evaluate the prognostic value of the preoperative ALBI status in patients with GC who received curative *** Patients with GC who underwent curative intended gastrectomy were retrospectively evaluated from our prospective *** score was calculated as follows:(log10 bilirubin×0.660)+(albumin×-0.085).The receiver operating characteristic curve with area under the curve(AUC)was plotted to evaluate the ability of ALBI score in predicting recurrence or *** optimal cutoff value was determined by maximizing Youden’s index,and patients were divided into low and high-ALBI *** Kaplan-Meier curve was used to analyze the survival,and the log-rank test was used for comparison between *** A total of 361 patients(235 males)were *** median ALBI value for the entire cohort was-2.89(IQR-3.13;-2.59).The AUC for ALBI score was 0.617(95%CI:0.556-0.673,P<0.001),and the cutoff value ***,211(58.4%)patients were classified as low-ALBI group and 150(41.6%)as high-ALBI *** age(P=0.005),lower hemoglobin level(P<0.001),American Society of Anesthesiologists classification III/IV(P=0.001),and D1 lymphadenectomy P=0.003)were more frequent in the high-ALBI *** was no difference between both groups in terms of Lauren histological type,depth of tumor invasion(pT),presence of lymph node metastasis(pN),and pathologic(pTNM)*** postoperative complication,and mortality at 30 and 90 days were higher in the high-ALBI *** the survival analysis,the high-ALBI group had worse disease-free survival(DFS)and overall survival(OS)compared to those with low-ALBI(P<0.001).

关键词： Stomach neoplasms Adenocarcinoma Albumin-bilirubin Biomarker Prognosis Survival

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Remnant gastric cancer:An ordinary primary adenocarcinoma or a tumor with its own pattern?

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World Journal of Gastrointestinal Surgery 2021年第4期13卷 366-378页

作者： Marcus Fernando Kodama Pertille Ramos Marina Alessandra Pereira andre roncon dias Anna Carolina Batista Dantas Daniel Jose Szor Ulysses Ribeiro Jr Bruno Zilberstein Ivan Cecconello Department of Gastroenterology Instituto do CancerHospital das Clínicas da Faculdade de Medicina da Universidade de São PauloSão PauloSão Paulo 01249000Brazil

BACKGROUND Remnant gastric cancer(RGC)is defined as a tumor that develops in the stomach after a previous gastrectomy and is generally associated with a worse ***,there little information available regarding RGCs and their prognostic factors and *** To evaluate the clinicopathological characteristics and prognosis of RGC after previous gastrectomy for benign *** Patients who underwent curative resection for primary gastric cancer(GC)at our institute between 2009 and 2019 were retrospectively *** RGC resections with histological diagnosis of gastric adenocarcinoma were enrolled in this *** proximal GC(PGC)who underwent total gastrectomy was selected as the comparison *** and pathological data were collected from a prospective medical *** A total of 41 patients with RGC and 120 PGC were *** age(P=0.001),lower body mass index(P=0.006),hemoglobin level(P<0.001),and number of resected lymph nodes resected(LN)(P<0.001)were associated with the RGC *** type,pathological tumor-node-metastasis,and perioperative morbimortality were similar between RGC and *** was no difference in disease-free survival(P=0.592)and overall survival(P=0.930)between *** status was the only independent factor related to *** RGC had similar clinicopathological characteristics to *** the lower number of resected LN,RGC had a similar prognosis.

关键词： Stomach neoplasms Gastric remnant Gastric cancer Remnant gastric cancer Peptic ulcer Gastric stump

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Immunohistochemical expression of thymidylate synthase and prognosis in gastric cancer patients submitted to fluoropyrimidine-based chemotherapy

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Chinese Journal of Cancer Research 2018年第5期30卷 526-536页

作者： Marina Alessandra Pereira Marcus Fernando Kodama Pertille Ramos andre roncon dias Sheila Friedrich Faraj Cinthya dos Santos Cirqueira EvANDro Sobroza de Mello Bruno Zilberstein Venancio Avancini Ferreira Alves Ulysses Ribeiro Jr Department of Gastroenterology Cancer InstituteUniversity of Sao Paulo Medical School Department of Pathology Cancer InstituteUniversity of Sao Paulo Medical School Department of Pathology Instituto Adolfo Lutz

Objective： Adjuvant chemotherapy with 5-fluorouracil （5-FU） has been widely used in gastric cancer （GC） patients to prevent relapse after curative resection. 5-FU acts by inhibiting thymidylate synthase （TS）, and high levels of TS correlate with resistance to treatment with fluoropyfimidines. The aim of this study was to evaluate the expression of TS in GC patients, and its relation with clinicopathological characteristics and prognosis in adjuvant chemotherapy with 5-FU. Methods： We retrospectively evaluated 285 patients who underwent D2-gastrectomy with curative intent. TS expression was determined by immunohistochemistry （IHC） in tumor cells by tissue microarray （TMA）. TS level was evaluated according to the intensity and percentage of cells marked by a score system. Patients were divided in three groups according to their TS-score： negative, low and high. Results： TS expression was positive in 92.3% of GC. TS-high, TS-low and TS-negative were observed in 46.3%, 46.0% and 7.7% of patients, respectively. High-TS GC were associated with older age （P=0.007）, high neutrophil/lymphocyte ratio （P=0.048）, well/moderately differentiated histology （P=0.001）, intestinal Lauren type （P〈0.001） and absence of perineural invasion （P=0.003）. Among 285 patients, 133 stage IUIII patients （46.7%） received chemotherapy with 5-FU. In survival analysis, TS-high was associated with worse disease-free survival （DFS） in stage III GC patients who received 5-FU-based chemotherapy （P=0.007）. Multivariate analysis revealed that total gastrectomy, poorly differentiated tumors and high TS-score were associated with worse DFS in stage III GC patients. Conclusions： High TS-score in stage III GC was associated with poor DFS in patients treated with fluoropyrimidine-based chemotherapy.

关键词： Gastric cancer adjuvant therapy thymidylate synthase 5-fluorouracil-based chemotherapy

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Jejunostomy in the palliative treatment of gastric cancer:A clinical prognostic score

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World Journal of Clinical Oncology 2021年第10期12卷 935-946页

作者： Marcus Fernando Kodama Pertille Ramos Marina Alessandra Pereira andre roncon dias Erica Sakamoto Ulysses Ribeiro Jr Bruno Zilberstein Sergio Carlos Nahas Department of Gastroenterology Instituto do CancerHospital das Clínicas da Faculdade de Medicina da Universidade de São PauloSão Paulo 01246000Brazil

BACKGROUND Clinical stage IV gastric cancer(GC)may need palliative procedures in the presence of symptoms such as *** palliative resection is not possible,jejunostomy is one of the ***,the limited survival of these patients raises doubts about who benefits from this *** To create a prognostic score based on clinical variables for 90-d mortality for GC patients after palliative *** We performed a retrospective analysis of Stage IV GC who underwent *** preoperative clinical variables were selected to define the score categories,with 90-d mortality as the main *** randomization,patients were divided equally into two groups:Development(J1)and validation(J2).The following variables were used:Age,sex,body mass index(BMI),American Society of Anesthesiologists classification(ASA),Charlson Comorbidity index(CCI),hemoglobin levels,albumin levels,neutrophil-lymphocyte ratio(NLR),tumor size,presence of ascites by computed tomography(CT),and the number of disease *** score performance metric was determined by the area under the receiver operating characteristic(ROC)curve(AUC)to define low and high-risk *** Of the 363 patients with clinical stage IVCG,80(22%)patients underwent *** were predominantly male(62.5%)with a mean age of 62.4 years *** randomization,the binary logistic regression analysis was performed and points were assigned to the clinical variables to build the *** high NLR had the highest *** ROC curve derived from these pooled parameters had an AUC of 0.712(95%CI:0.537–0.887,P=0.022)to define risk *** the validation cohort,the diagnostic accuracy for 90-d mortality based on the score had an AUC of 0.756,(95%CI:0.598–0.915,P=0.006).According to the cutoff,in the validation cohort BMI less than 18.5 kg/m2(P<0.001),CCI≥1(P=0.001),ASA III/IV(P=0.002),high NLR(P=0.012),and the presence of ascites on CT exam(P=0.004)were significantly assoc

关键词： Stomach neoplasms Gastric cancer Palliative surgery Jejunostomy Gastric cancer with outlet obstruction Stage IV gastric cancer

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Litter production and leaf nutrient concentration and remobilization in response to climate seasonality in the central Amazon

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Journal of Forestry Research 2024年第3期35卷 131-141页

作者： Ricardo Antonio Marenco Saul Alfredo Antezana-Vera Daniela Pereira dias Luiz Antonio Candido Instituto Nacional de Pesquisas da Amazonia Coordenagao de Uso da Terra e Mudanca ClimaticaAv.Andre Araujo 2936ManausAM69067-375Brazil Programa de pos-Graduagao em Agricultura no Tropico Umido Instituto Nacional de Pesquisas da Amazonia-INPAManausAMBrazil Unidade Academica de Ciencias Agrarias Universidade Federal de JataiBR 364km 195JataiGO 75801-615Brazil

Litterfall is the largest source of nutrients to for-est soils of tropical ***,variability in lit-terfall production,nutrient remobilization,and changes in leaf nutrient concentration with climate seasonality remain largely unknown for the central *** study meas-ured litterfall production,leaf nutrient remobilization,and leaf area index on a forest plateau in the central *** was measured at monthly intervals during 2014,while nitrogen,phosphorus,potassium,calcium and mag-nesium concentrations of leaf litter and canopy leaves were measured in the dry and rainy seasons,and remobilization rates *** area index was also recorded in the dry and rainy *** litterfall varied from 33.2(in the rainy season)to 87.6 g m^(-2) in the dry season,while leaf area index increased slightly in the rainy *** seasonality had no effect on concentrations of nitrogen,calcium,and magnesium,whereas phosphorous and potassium responded to rainfall seasonality *** phosphorous increased,potassium decreased during the dry *** seasons,nitrogen,potassium,and phosphorous decreased in leaf litter;calcium increased in leaf litter,while magnesium remained unaffected with leaf ***,the five nutrients had similar remobilization rates over the *** absence of climate seasonality on nutrient remobilization suggests that the current length of the dry season does not alter nutrient remobilization rates but this may change as dry periods become more prolonged in the future due to climate change.

关键词： Throughfall Nutrient cycling Climatic seasonality Leaf mass per area

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Biliary stone causing afferent loop syndrome and pancreatitis

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World Journal of Gastroenterology 2006年第38期12卷 6229-6231页

作者： André roncon dias Roberto Iglesias Lopes Department of General Surgery Hospital das Clínicas Faculdade de Medicina da Universidade de So Paulo So Paulo Brazil

We report the case of an 84-year-old female who had a partial gastrectomy with Billroth-Ⅱ anastomosis 24 years ago for a benign peptic ulcer who now presented an acute pancreatitis secondary to an afferent loop syndrome. The syndrome was caused by a gallstone that migrated through a cholecystoenteric fistula. This is the first description in the literature of a biliary stone causing afferent loop syndrome.

关键词： Afferent loop syndrome Biliary stone Acute pancreatitis Gallstone ileus

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Modelling the role of ground-true riparian vegetation for providing regulating services in a Mediterranean watershed

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International Soil and Water Conservation Research 2023年第1期11卷 159-168页

作者： Bruno A.Aparício João Pedro Nunes Léonard Bernard-Jannin Luis Filipe dias andre Fonseca Teresa Ferreira cE3c-Centre for Ecology Evolution and Environmental Changes&CHANGE-Global Change and Sustainability InstituteFaculty of SciencesUniversity of LisbonLisbonPortugal Forest Research Centre&Laboratory TERRA School of AgricultureUniversity of LisbonLisbonPortugal Soil Physics and Land Management Group Wageningen University and ResearchWageningenNetherlands Longline Environment Ltd LondonUK

Intensive agricultural and industrial activities are often considered major sources of water ***,riparian vegetation(RV)is increasingly being promoted as a solution to balance the potentially adverse effects that agriculture may have on water ***,existing RV is often overlook in recent modelling efforts,failing to capture the current amount of ecosystem services ***,we used the Soil and Water Assessment Tool ecohydrological model to simulate the influence of ground-true RV on i)nutrient(nitrate and total phosphorus)and sediment exports from agricultural areas and ii)its effect for in-stream *** results are further compared against a set of hypothetical scenarios of different RV widths and different *** results point to a great rele-vance of existing RV in controlling in-stream concentration of sediments and nutrients where pressure from agriculture is highest,preventing them to surpass limits set in the EU Water Framework *** the other hand,in areas with industry discharges,the role of RV is limited and model results suggest that restoring RV would have limited *** illustrate how existing RV may already provide strong but not acknowledged water quality regulation services,how these services can differ substantially between nearby streams,and that effective strategies to improve water quality using RV must acknowledge existing patterns of vegetation,land use and contamination sources.

关键词： Agricultural pollution Riparian vegetation Ecosystem services Hydrological services Mediterranean region

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Prognostic implications of tumor-infiltrating lymphocytes in association with programmed cell death ligand 1 expression in remnant gastric cancer

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Chinese Journal of Cancer Research 2022年第6期34卷 612-622页

作者： Marina Alessandra Pereira Marcus Fernando Kodama Pertille Ramos André roncon dias Leonardo Cardili Rafael Dyer Rodrigues de Moraes Renan Ribeiro E Ribeiro Venancio Avancini Ferreira Alves Bruno Zilberstein Evandro Sobroza de Mello Ulysses Ribeiro Jr Department of Gastroenterology Instituto do Cancer do Estado de Sao PauloHospital das ClinicasFaculdade de MedicinaUniversidade de Sao Paulo(ICESP-HCFMUSP)Sao PauloSP 01246-000Brazil Department of Pathology Instituto do Cancer do Estado de Sao PauloHospital das ClinicasFaculdade de MedicinaUniversidade de Sao Paulo(ICESP-HCFMUSP)Sao PauloSP 01246-000Brazil

Objective:Remnant gastric cancer(RGC)is usually associated with a worse *** they are less common and very heterogeneous tumors,new prognostic and reliable determinants are required to predict patients’clinical course for *** study aimed to investigate the tumor-infiltrating lymphocytes(TILs)and programmed cell death ligand 1(PD-L1)status as prognostic biomarkers in a cohort of patients with RGC to develop an immunerelated ***:Patients with gastric cancer(GC)who underwent curative intent gastrectomy were retrospectively *** resections with histological diagnosis of gastric adenocarcinoma were enrolled in the *** risk score based on immune parameters was developed using binary logistic regression *** were divided into high-risk(HR),intermediate-risk(IR),and low-risk(LR)groups based on their immune *** markers(CD3+,CD4+/CD8+T cells and PD-L1)were selected for their potential prognostic,therapeutic value,and evaluated by immunohistochemistry(IHC).Results:A total of 42 patients with RGC were enrolled in the *** score based on immune parameters exhibited an accuracy of 79%[the area under the receiver operating characteristic curve(AUC)=0.79,95%confidence interval(95%CI),0.63-0.94,P=0.002],and the population was divided into 3 prognostic groups:10(23.8%)patients were classified as LR,15(35.7%)as IR,and 17(40.5%)as HR *** were no differences in clinicopathological and surgical characteristics between the three *** survival analysis,HR and IR groups had worse disease-free survival and overall survival rates compared to the LR *** the multivariate analysis,lymph node metastasis and the immune score risk groups were independent factors related to worse ***:A scoring system with immune-related markers was able to distinguish prognostic groups of RGC associated with ***,tumor-infiltrating immune lymphocytes and PD-L1 status may serve as a potential prognostic bi

关键词： Stomach neoplasms gastric remnant tumor-infiltrating lymphocytes immune microenvironment

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Short-term complementary and alternative medicine on quality of life in women with fibromyalgia

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Journal of Integrative Medicine 2016年第1期14卷 29-35页

作者： Paulo Araujo dias andre Brito Bastos Guimaraes andrea de Oliveira Albuquerque Karoline Lucas de Oliveira Maria Luzete Costa Cavalcante Sergio Botelho Guimaraes Faculty of Medicine Department of SurgeryFederal University of Ceara60430-140FortalezaBrazil Faculty of Pharmacy Dentistry and NursingFederal University of Ceara60430-160FortalezaBrazil

BACKGROUND： Fibromyalgia （FMS） is a syndrome characterized by chronic widespread musculoskeletal pain, whose etiology is not completely understood. Different therapeutic approaches have been used with inconsistent results. This observation does not invalidate the continued search for alternative treatments aimed at improving quality of life （QoL） in FMS. OBJECTIVE： This study compared three classica acupuncture （AC）, electroacupuncture （EAC） and promotion of QoL in FMS patients. traditional Chinese medicine （TCM） therapies： moxibustion （MX） in the management of pain and DESIGN, SETTING, PARTICIPANTS AND INTERVENTIONS： A preliminary, group-assigned, comparative study enrolled 30 women, mean age （46.90_＋9.24） years （range 20-60 years）, who met the 1990 American College of Rheumatology criteria for FMS diagnosis and a pain-pressure threshold （PPT）〈 4 kg/cm2. The study was conducted in a teaching tertiary-care medical institution from May 2010 through April 2012. AC, EAC and MX were delivered for 30 min, once a week, for 8 weeks, bilaterally at Neiguan （PC6）, Hegu （LI4）, Yanglingquan （GB34）, Sanyinjiao （SP6） and Taichong （LR3） acupoints. MAIN OUTCOME MEASURES： Each week, immediately before treatment and after treatment, subjects were tested for PPTs, Wong-Baker Faces Pain Scale （WBFPS; for pain intensity） and Medical Outcomes Study 36-item Short Form Health Survey （SF-36： for QoL）. RESULTS： There was no significant improvement in pain or reduction of tender points in any of the groups studied, at the end of the 8th session. Significant improvement of QoL was perceived in vitality （after AC treatment） and in mental health （after EAC and MX treatments）. CONCLUSION： TCM therapies （AC, EAC and MX） promoted an improvement in the QoL in two areas （vitality and mental health） in FMS women. Further large-scale clinical trials are required to confirm this effect.

关键词： quality of life medicine, Chinese traditional acupuncture therapy women

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Stable isotopes and body composition in children: History, fundamentals, and clinical applications

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Health 2013年第8期5卷 61-68页

作者： Wendell Costa Bila Joel Alves Lamounier andre Everton de Freitas Valmin Ramos Silva Sylvia dias Turani Jose Eduardo Dutra de Oliveira Graduate Program in Health Sciences Federal University of Sao Joao Del Rei-West Campus CenterDivinopolisBrazil Graduate Program in Child and Teenager Health-Medicine School-UFMG Belo Horizonte College of Health and Human Ecology-FASEH VespasianoBrazil Faculty of Medicine School of Sciences of Santa Casa de Misericordia of VitoriaNossa Senhora da Gloria Children’s HospitalVitoriaBrazil Faculty of Medicine Federal University of Sao Joao Del Rei-West Campus CenterDivinopolisBrazil Faculty of Medicine University of Sao Paulo-Ribeirao PretoBrazil

The aim of this study was to gather information on the use of stable isotopes to measure total body water and body composition scan in children. We selected studies in the last 13 years, in addition to classical studies on the subject, indexed in the database PubMed, LILACS, BVS and SciELO. The body composition was characterized by the amount of bone tissue, muscle and adipose tissue, also including the organs as well as levels of body water. Your knowledge becomes increasingly important in light of the changes that occur in the nutritional status of various types of diseases in frameworks, such as diabetes mellitus, protein energy malnutrition, in cases of obesity and metabolic syndrome. The ability to accurately assess body fat mass especially in children is associated with the importance of effective strategies for prevention and treatment of childhood obesity. Historically, in addition to clinical applications, measurements of total body water were used to determine body composition in nutritional studies. To the knowledge of the body composition, the body water can be measured and used by the ingestion of a dose of labeled water. The measured isotope enrichment is a function of the amount of body water. The method of deuterium is particularly interesting for the assessment of body composition in children, due to its characteristics of collection and analysis.

关键词： Body Water Deuterium Body Composition Doubly Labeled Water Obesity Children

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